The North Coast Cholesterol Check Campaign. Results of the first three years of a large-scale public screening programme.

Although cardiovascular disease (CVD) mortality has been declining, CVD is still the major cause of death in Australia and an elevated blood cholesterol level is considered a major contributor. Large-scale community-based screening programmes in other countries have demonstrated that a population approach can be effective in reducing cholesterol levels and the risk of CVD. The North Coast Cholesterol Check Campaign is the largest community-based cholesterol intervention programme in Australia. Since its inception in 1987, 13% of the Region's adult population (over 29,000 persons) have been screened. About half had elevated blood cholesterol levels (greater than or equal to 5.5 mmol/L) and were given dietary counselling to reduce fat intake. Mean blood cholesterol levels were significantly reduced between initial screening and follow-up in all three years. Reductions, after correction for regression, were 8%, 6% and 10%, respectively, in 1987, 1988 and 1989. There was also a consistent and significant 1.5% to 2% reduction in weight. All age/sex cohorts above age 35 were well represented each year although self-referral did bias both initial and follow-up samples towards women and the aged. Nevertheless, the proportion of men and men in their middle age increased during the three years. The proportion of participants with elevated cholesterol levels increased in each successive year while the proportion of participants who complied with referrals to visit their general practitioner and with requests to return for follow-up decreased. Over half of the North Coast adult population has now had a cholesterol test. The rate of increase in testing since the inception of the Campaign has been approximately four times the national rate. North Coast general practitioners have played a major role by catering for the increased community demand for cholesterol testing and by providing an effective referral service for the Campaign. Community-based screening programmes in Australia can detect and beneficially influence large numbers of persons with elevated cholesterol levels. Interventions like the North Coast Cholesterol Check Campaign, when conducted over a number of years, do attract higher risk and less compliant people.(ABSTRACT TRUNCATED AT 250 WORDS)