| Summary: | PURPOSE: Both the US Preventive Services Task Force (USPSTF) and the National Cholesterol Education Program (NCEP ATP III) have issued recommendations on screening for dyslipidemia in adults. To guide the USPSTF in updating its 2001 recommendations, we reviewed evidence relevant to discrepancies between these recommendations. DATA SOURCES: A 2001 evidence review prepared for the USPSTF, supplemented by searches of the Cochrane Library, MEDLINE, EMBASE, and reference lists of recent systematic reviews. STUDY SELECTION: Randomized controlled trials and observational studies published between December 1999 and February 2005 that addressed screening in younger patients not at high risk; use of triglyceride levels in an initial screening panel; optimal screening intervals; selection of patients for treatment; and harms of drug therapy. DATA EXTRACTION: We abstracted data on the design, results, and quality of each included trial. We used standard USPSTF methods to rate the internal validity of trials and epidemiologic studies. DATA SYNTHESIS: New evidence relevant to discrepancies between USPSTF and ATP III recommendations was summarized in the context of earlier evidence. LIMITATIONS: This document should be read in conjunction with the full systematic evidence review conducted for the USPSTF in 2001, the final report of ATP III, and the 2004 ATP III update. CONCLUSIONS: There is no new evidence relevant to screening younger adults or to appropriate screening intervals. Evidence is conflicting regarding the additional contribution of a serum triglyceride level to the identification of individuals at short-term risk for coronary heart disease events. The balance of benefits and harms is clearly in favor of statin therapy among individuals enrolled in some, but not all, randomized trials of primary prevention. The long-term harms of statin therapy are unknown
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