Testing
Lp(a) meets most established criteria for a population screening test, on health, societal and cost grounds, review by Koschinsky and Thanassoulis's group argues (Eur J Prev Cardiol 2025)
Original title: Rationale for the Routine Screening of Lipoprotein (a) in Cardiovascular Risk Assessment
This review by Iatan, Koschinsky, Thanassoulis and colleagues evaluates whether Lp(a), causally linked to atherosclerotic cardiovascular disease and aortic stenosis across ethnicities by Mendelian randomisation studies, meets the accepted criteria used to select a new analyte for population screening programmes. The authors note that the cardiovascular risk conferred by markedly elevated Lp(a) equals that of untreated familial hypercholesterolaemia, yet clinicians have historically hesitated to measure it routinely, despite European and Canadian lipid guidelines and the National Lipid Association now recommending universal screening. Assessed against established screening principles, Lp(a) meets the majority of criteria on health, societal and cost grounds. The authors conclude that incorporating Lp(a) into global cardiovascular risk assessment would generate healthcare savings, align practice with a growing body of guidelines and consensus statements, and advance proactive preventive medicine.
Original abstract
Lipoprotein(a) [Lp(a)] is a lipid particle identified by Mendelian randomization studies to be causally associated with the development of atherosclerotic cardiovascular disease and aortic stenosis, across ethnicities. The risk of cardiovascular disease with markedly elevated Lp(a) is equal to that of untreated familial hypercholesterolemia, and yet, up until now, there has been hesitancy in measuring Lp(a) as a routine part of cardiovascular risk assessment. Screening of Lp(a) level in all individuals is now recommended in the European and Canadian Lipid Guidelines and by the National Lipid Association. This review assesses how well measurement of Lp(a) meets accepted criteria for population screening of an analyte, based on established principles used for the selection of a new candidate for inclusion in screening programs. Lp(a) meets the majority of recommended principles for a routine population screening test, based on health, societal, and cost considerations. Incorporating Lp(a) into global assessment and management of cardiovascular risk will result in savings to health care systems, reinforce recommendations from growing numbers of clinical guidelines and consensus statements, and increase implementation of proactive preventive medicine.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.