Pilot study of universal screening of children and child‐parent cascade testing for familial hypercholesterolaemia in Australia

Andrew C Martin, Amanda J Hooper, Richard Norman, Lan T Nguyen, John R Burnett, Damon A Bell, Tom Brett, Jacquie Garton‐smith, Jing Pang, Kristen J Nowak, Gerald F Watts

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Aim Familial hypercholesterolaemia (FH) is a common and treatable cause of premature coronary artery disease. However, the majority of individuals with FH remain undiagnosed. This study investigated the feasibility, acceptability and cost-effectiveness of screening children aged 1–2 years for FH at the time of an immunisation. Methods Children 1–2 years of age were offered screening for FH with a point-of-care total cholesterol (TC) test by capillary-collected blood sample at the time of an immunisation. An additional blood sample was taken to allow genetic testing if the TC level was above the 95th percentile (>5.3 mmol/L). Parents of children diagnosed with FH were offered testing. Following detection of the affected parent, cascade testing of their first-degree blood relatives was performed. Results We screened 448 children with 32 (7.1%) having a TC ≥ 5.3 mmol/L. The FH diagnosis was confirmed in three children (1:150 screened). Reverse cascade testing of other family members identified a further five individuals with FH; hence, eight new cases of FH were diagnosed from screening 448 children (1:56 screened). Ninety-six percent of parents would screen future children for FH. The approach was cost-effective, at $3979 per quality-adjusted life year gained. Conclusion In Western Australia, universal screening of children aged 1–2 years for FH, undertaken at the time of an immunisation, was a feasible and effective approach to detect children, parents and other blood relatives with FH. The approach was acceptable to parents and is potentially a highly cost-effective detection strategy for families at risk of FH.
Original languageEnglish
Pages (from-to)281-287
Number of pages7
JournalJournal of Paediatrics and Child Health
Issue number2
Early online date13 Aug 2021
Publication statusPublished - Feb 2022


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