Is now the time for cholesterol screening?

Is now the time for cholesterol screening?

Next to the now-familiar blood-pressuremachine at your nearby shopping mall may soon be a cholesterol-screening device. Health officials met last week to discuss a proposed, massive nationwide cholesterol screening program--now spurred on by a recent study showing newly developed testing methods could make "shopping-mall' acreening possible.

But medical experts say that nestledamong the obvious benefits from knowing and, if results are abnormal, lowering your blood cholesterol are some troublesome aspects, such as the failure of many physicians to adequately counsel patients about cholesterol and the confusion as to what effects lowering cholesterol actually has on health. Abnormal cholesterol levels have been tied to increased heart disease and cancer risk (SN: 1/3/87, p.4), yet the magnitude of cholesterol's effects have been questioned (SN: 4/25/87, p.261).

Representatives from state and federalhealth departments, medical associations, and industry debated those issues last week in Washington, D.C. at a meeting hosted by Baylor College of Medicine in Houston and the George Washington University Medical Center in Washington, D.C. Discussion revolved around the concurrent release of results from a study by 11 lipid research clinics across the United States that evaluated a rapid, automated assay requiring only a fingerstick sample of blood.

After testing the assay on nearly 13,000people at schools, work sites, shopping malls and other locations, researchers said last week that new technology has made mass screening for cholesterol a practical goal. The study used a $4,000 desk-top machine developed by Boehringer Mannheim Diagnostics of Indianapolis, which sponsored the study. According to those reporting the results, the method determines cholesterol levels within three minutes, giving results that vary about 1 to 4 percent from rigorous, standarized laboratory tests used for comparison. With its accuracy, speed and lower test cost (about $3 per test versus an average $20 for current testing), the Boehringer machine--and similar equipment from other companies--was touted as the technological vehicle for which mass screening has been waiting.

However, reducing the 550,000 U.S.deaths each year from coronary heart disease will take more than technology, say those who cite studies showing physicians may be reluctant to participate despite public enthusiasm. For that reason, the cholesterol-screening bandwagon may be slow to roll, say scientists and physicians who support a screening program as part of the 18-month-old National Cholesterol Education Program being coordinated by the National Institutes of Health. Baylor's Michael E. DeBakey says that screening for cholesterol "should be just as effective as screening for hypertension [blood pressure] in controlling a major risk factor for coronary heart disease.'

Other anticipated problems of widespreadscreening would be maintaining machines in non-medical settings, as well as deciding who should be screened, and assuring that those with high cholesterol seek medical advice and adjust their diet.