I’ve written here about the recommendation that children be routinely screened for lipid (cholesterol, etc) levels. I pointed out that there was no scientific evidence that such screening would convey a health benefit. An opinion piece in the Journal of the American Medical Association reaches the same conclusion.

The robust evidence that high levels of low-density lipoprotein (LDL) cholesterol are a cause of atherosclerosis and clinical events is not matched by similar levels of evidence that long-term, perhaps lifelong, drug treatment in young children is effective and safe…The recommendations of the expert panel represent an intervention for which the long-term risk-benefit profile also remains uncertain…In the expert panel’s report, the complex algorithms for initiating drug treatment of lipid levels in children receive all the highlighted emphasis that comes with large tables and long discussion…What this novel public health intervention in children clearly lacks is an evaluation to determine whether the long-term risk-benefit profile may in fact be favorable or harmful.

You can read the whole piece for yourself using the link above. There is one statement it makes that is questionable. In adults, the health benefits of statins are well demonstrated. In a meta-analysis of 10 primary prevention clinical trials, statin use was associated with a 30% reduction (95% CI, 19%-39%) in coronary events and a 12% reduction (95% CI, 4%-19%) in total mortality. It sites this study, but ignores a more recent meta-analysis which found no evidence for the benefit of statin therapy on all-cause mortality in a high-risk primary prevention set-up.

Regardless, of the putative benefit of primary prevention in adults, lipid screening in children and young adults is a bad idea which violates the tenants of evidence based medicine which seem easy to discard whenever they stand in the way of a favored theory. I shouldn’t have to say this, but the evidence is supposed to precede the recommendation. The expert panel seems to have forgotten this in their rush to judgement.