Background: This review updates prior reviews on screening for lipid disorders in adults, and will be used by the U.S. Preventive Services Task Force (USPSTF) to update its 2008 recommendation. Unlike prior USPSTF reviews, this one focuses on screening in younger adults, defined as adults ages 21 to 39 years, as there is more uncertainty about the need to perform lipid screening in this population than in older adults.
Data Sources: We searched the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Ovid MEDLINE from 2008 through May 2016 and manually reviewed reference lists.
Study Selection: Two investigators independently reviewed the literature for studies on screening for and treatment of dyslipidemia in asymptomatic adults ages 21 to 39 years, including randomized, controlled trials, case-control studies, cohort studies, and good-quality systematic reviews.
Results: No study evaluated the effects of lipid screening versus no screening, treatment versus no treatment, or delayed versus earlier treatment on clinical outcomes in younger adults. In addition, no study evaluated the diagnostic yield of alternative screening strategies in younger adults (e.g., targeted screening of persons with a family history of hyperlipidemia vs. general screening). Longitudinal studies suggest that lipid levels have a tendency to increase over time in younger adults, though no study evaluated how lipid levels change according to different intervals between repeat testing or the proportion of patients who would move from one risk category to another.
Limitations: Lack of direct evidence in younger adults.
Conclusions: Direct evidence on benefits and harms of screening for or treatment of dyslipidemia in younger adults remains unavailable.