Levels of serum cholesterol have been correlated with a person's subsequent risk of heart disease. Clinical studies have shown that serum cholesterol screening may reduce the risk of heart disease.
Cholesterol skin testing is a non-invasive test that entails placement of a few drops of fluid in the fleshy area of the palm near the base of the thumb and measurement of the resulting color change with a special device. The new test, known as Cholesterol 1,2,3(TM) (IMI International Medical Innovations Inc., Toronto, Canada), does not involve fasting or waiting hours or days for results, instead being available in three minutes. Well-designed clinical trials are needed to ascertain the effectiveness of cholesterol skin testing in predicting CHD as compared to standard methods of cholesterol testing (e.g. blood cholesterol tests).
The current recommendation is that everyone get a fasting lipid profile every five years starting at age 20 if the results are in the desirable range. If the results are high, or if you have a family history of coronary artery disease, you should be tested more frequently.
The American College of Physicians, the U.S. Preventive Services Task Force, and the Canadian Task Force on the Periodic Health Examination recommend measuring serum cholesterol every five years, starting in early adulthood.
The U.S. Preventive Services Task Force (USPSTF) recommends periodic total serum cholesterol and high-density lipoprotein cholesterol (HDL-C) screening for all men aged 35 and older and all women aged 45 and older. The USPSTF recommends screening beginning at age 20 for men and women with other risk factors for coronary heart disease, such as:
They recommended an interval of 5 years between tests, but longer intervals may be reasonable in low-risk subjects, including those with previously desirable cholesterol levels. For average risk individuals, the benefit of measuring triglycerides as an initial screening is unproven.
The USPSTF recommends screening with total cholesterol, HDL-C, and lipoprotein analysis for persons with major coronary heart disease risk factors (e.g. smoking, hypertension or diabetes). These guidelines recommend, for high-risk persons, lipoprotein analysis to help identify individuals at highest risk of coronary heart disease (CHD) in whom individual diet or drug therapy may be indicated. The optimal frequency of screening has not been determined and is left to clinical discretion.
The American College of Physicians (ACP) – American Society of Internal Medicine, in guidelines revised in 1996, concluded that screening serum cholesterol was appropriate but not mandatory for asymptomatic men aged 35 to 65 and women aged 45 to 65; the guidelines do not recommend screening for younger persons unless they have evidence of having a familial lipoprotein disorder or have multiple cardiac risk factors. The ACP concluded that evidence was not sufficient to recommend for or against screening asymptomatic persons between the ages of 65 and 75, but the ACP recommends against screening after age 75.
In addition, the National Cholesterol Education Program (NCEP) recommends routine measurement of a fasting lipoprotein profile (total cholesterol, LDL cholesterol, high density lipoprotein (HDL) cholesterol, and triglyceride) in all adults age 20 and older at least once every 5 years. The American Academy of Family Physicians recommends measurement of total cholesterol at least every 5 years in adults age 19 and older.
The American College of Obstetricians and Gynecologists recommends periodic screening of cholesterol in all women over age 20.