Screening check
Should my child get a cholesterol test?
About 1 in 250 to 500 US children has familial hypercholesterolemia, an inherited cause of very high cholesterol, and high cholesterol from other causes is far more common. The US Preventive Services Task Force looked at whether children and teens without symptoms should be screened. Check what it says for your child.
About your child
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What you will see
What the USPSTF and other groups say about a cholesterol test for your child.
Educational only, not medical advice. This is not a cholesterol test. Ask your child's clinician about testing.
Source
US Preventive Services Task Force, July 2023 recommendation on screening for lipid disorders in children and adolescents, including the recommendations of other groups it summarizes.
Validated in
Children and adolescents 20 or younger without signs or symptoms of a lipid disorder.
Limits
It is not a cholesterol test. It does not cover children already diagnosed with a lipid disorder or high cholesterol caused by another condition.
What the USPSTF recommends
| Who | Recommendation | Grade |
|---|---|---|
| Children and adolescents 20 or younger without symptoms | Evidence is insufficient to weigh the benefits and harms of screening for lipid disorders | I |
This matches the USPSTF's 2016 conclusion. Without clear evidence, clinicians are encouraged to use their judgment about screening (USPSTF 2023). Other groups go further: the National Heart, Lung, and Blood Institute, the American Academy of Pediatrics' Bright Futures program and the 2018 multisociety cholesterol guideline recommend screening all children at ages 9 to 11 and again at 17 to 21, and screening children with a family history of heart disease or high cholesterol, or other risk factors, as early as age 2 (USPSTF 2023).
Why it matters
High cholesterol over many years can lead to early hardening of the arteries and to heart attacks, strokes or death in adulthood (USPSTF 2023). Familial hypercholesterolemia usually causes no symptoms in childhood, but it can start changing the arteries as early as age 8 (USPSTF 2023). Among US 6- to 19-year-olds, 19.2% had at least one abnormal lipid level in 2013 to 2016 national survey data (USPSTF 2023).
Why the evidence falls short
No study looked directly at whether screening children prevents heart attacks or deaths later in life. Treatment trials in children with familial hypercholesterolemia were small and short, and none reported effects on heart events or deaths, although statins lowered cholesterol the most (USPSTF 2023). No studies reported on the harms of screening itself (USPSTF 2023).
Common questions
Is family history enough to decide who gets tested?
Not reliably. In one study of fifth graders, 1.2% of those with a family history of early heart disease and 1.7% of those without one had an LDL cholesterol of 160 mg/dL or higher, so testing only children with a family history would miss many cases. Family reports are also often inaccurate, and the inherited condition is not related to weight (USPSTF 2023).
Can children take statins?
Statins are approved by the US Food and Drug Administration for children 8 and older and are the first medicine used for children with high LDL cholesterol. Other options include changes to diet and physical activity and supplements such as plant sterols (USPSTF 2023).
Also see the LDL calculator, the blood lead test check and all screening tests by age.
Sources
- US Preventive Services Task Force. Screening for Lipid Disorders in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. JAMA. 2023;330(3):253-260. www.uspreventiveservicestaskforce.org/uspstf/recommendation/lipid-disorders-in-children-screening
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-10-30. Spotted an error? See About.