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Universal capillary screening for chronic autoimmune, metabolic and cardiovascular diseases: feasibility and
Sara Angiulli1, Aurora Merolla1, Elisa Borgonovo1
1Vita-Salute San Raffaele University, Milan, Italy.
Insights
Universal screening for chronic autoimmune and metabolic diseases using fingerprick blood tests is feasible and acceptable in the general population. This approach simplifies disease risk marker detection for conditions like type 1 diabetes and hypertension.
Area of Science:
- Public Health
- Preventive Medicine
- Clinical Diagnostics
Background:
- The UNISCREEN study investigated the feasibility and acceptability of universal screening for chronic autoimmune (type 1 diabetes, celiac disease) and metabolic/cardiovascular diseases (dysglycemia, type 2 diabetes, dyslipidemia, hypertension).
- Screening was conducted across all age groups using minimally invasive capillary blood sampling via fingerprick.
Purpose of the Study:
- To evaluate the feasibility of implementing a universal screening program for chronic autoimmune and metabolic diseases in a general population.
- To assess the acceptability of capillary blood sampling and immediate feedback for disease risk markers among participants of all ages.
Main Methods:
- The study involved 1,535 participants from a general population, aged 1-100 years, in Cerro Maggiore, Milan, Italy.
- Procedures included capillary blood collection for immediate metabolic tests and autoantibody assays, blood pressure measurement, and physician consultations.
- Feasibility and acceptability were assessed through questionnaires administered before and after the screening process.
Main Results:
- A single fingerprick was sufficient for all measurements in 47.1% of participants, with up to two needed in 86.9%.
- Complete metabolic panels were obtained in 90.0%, and sufficient serum for autoantibody testing in 99.7%.
- Over 90% found capillary sampling simple and practical, preferring it to venous sampling, with reduced pre-screening anxiety post-consultation.
Conclusions:
- Universal screening for chronic autoimmune, metabolic, and cardiovascular diseases is feasible in the general population.
- Capillary blood testing via fingerprick is an acceptable and practical method for widespread disease risk assessment.
- The UNISCREEN study demonstrates a viable approach for early detection and risk stratification of common chronic diseases.
Background:
UNISCREEN is a general population study aiming at evaluating feasibility and acceptability of universal screening for chronic autoimmune (type 1 diabetes and celiac disease) and metabolic/cardiovascular diseases (dysglycemia, type 2 diabetes, dyslipidemia, hypertension) across all age groups using capillary blood sampling by fingerprick to measure disease risk markers.
Methods:
UNISCREEN was conducted in the Cantalupo fraction, Cerro Maggiore, Milan, Italy, counting 3,061 inhabitants between 1 and 100 years of age. Participation was voluntary, following a public call. Participants were invited to respond to feasibility and acceptability questionnaires immediately before and after the screening procedures, which included the following: capillary blood drawing for immediate measurement of metabolic parameters (glucose, glycated hemoglobin, total-, HDL- and calculated LDL-cholesterol, triglycerides) and late autoantibody assays; blood pressure measurement; brief consultation with a physician providing feed-back on immediate results and health recommendations. The study was registered as ClinicalTrials.gov NCT05841719.
Results:
The study included 1,535 participants (50.1% of local population). A single fingerprick was sufficient for all measurements in 47.1% of cases, while up to two were necessary in 86.9% of cases. Complete glucose and lipid panels were obtained in 1382 participants (90.0%). Sufficient serum for late autoantibody testing was obtained in 99.7% of participants. The questionnaires showed overall satisfaction, with over 90% of participants considering capillary sampling simple and practical, and preferring it to venous sampling. Before screening, 24.0% adults and 31.7% children's parents were worried about the possibility of being diagnosed or identified as being at risk; worries decreased to 21.3 and 23.4%, respectively, after medical consultation. The immediacy of some result communication possibly contributed to reducing the anticipatory anxiety.
Conclusion:
The UNISCREEN study shows that universal screening for chronic autoimmune, metabolic and cardiovascular diseases in the general population using capillary blood testing is feasible and acceptable.
