USPSTF: Evidence lacking for lipid disorder screening in children

The U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient for assessing the benefits and harms of lipid disorder screening in a pediatric population. These findings form the basis of a draft recommendation statement published by the USPSTF on Jan. 24.

Janelle M. Guirguis-Blake, M.D., from the Kaiser Permanente Evidence-based Practice Center in Portland, Oregon, and colleagues conducted a systematic review to examine the effectiveness and harms of screening and treatment of pediatric dyslipidemia due to familial hypercholesterolemia (FH) and multifactorial dyslipidemia. Data were included from 26 studies (437,000 participants) of FH; nine (143,265 participants) of multifactorial dyslipidemia; and nine (10,624 participants) of FH or multifactorial dyslipidemia.

The researchers found no direct evidence from population-based screening trials addressing the benefits and harms of screening for FH or multifactorial dyslipidemia. The strongest evidence on treatment benefit was seen for statins in FH children and adolescents, which was mainly based on small, short-term studies. Most of the evidence on statin harms came from small, short-term studies and limited longer-term evidence.

Based on these findings, the USPSTF concludes that the current evidence is inadequate for examining the balance of benefits and harms of screening for lipid disorders in a pediatric population aged 20 years or younger (I statement).

The draft recommendation statement and evidence review are posted for public comment. Comments can be submitted from Jan. 24 through Feb. 21, 2023.