adult screening programme

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Sudden cardiac death

SCD is the sudden and unexpected death of a person caused by a problem with their heart. The causes in people under the age of 39 are often a thickening of the heart muscle or an electrical problem with the heart. In older people, SCD is more likely to be caused by a narrowing of the blood vessels that supply the heart.

Screening might help by identifying heart conditions at an early stage before they cause symptoms. This in turn would allow treatment to start earlier.

UK NSC screening recommendation Based on the last UK NSC review of this condition that occurred in December 2019.

Screening is not currently recommended for this condition.

Based on the last review of this condition that occurred in December 2019, the UK NSC does not currently recommend systematic population screening of people under the age of 39 for cardiac conditions associated with sudden cardiac death (SCD).

The review found that SCD in young people is an important health problem. The effects of SCD can have a devastating impact on the affected individual and beyond. Our public consultation received many responses from the families and friends of people who lost their lives to SCD. They also drew attention to its even wider impact on the communities in which the families and friends live and work.

The UK NSC very carefully considered the recommendation on screening to prevent SCD. The result of the committee’s consideration was that a screening programme in all young people under the age of 39 should not be offered in the UK for the following important reasons identified by this review.

The test

A screening test must reliably identify people at risk of the condition, or outcome, the screening programme aims to prevent. This is because incorrect test results can cause harm. People with the condition who are missed by screening can be given false reassurance. People without the condition who receive positive test results can be given unnecessary tests and treatments. In these ways, screening can cause unintended harm.

The review found that most of the research on the different tests is in professional athletes whose hearts have different characteristics from non-athletes/the general population. Research like this is important. But tests can work in different ways in different groups of people. So, the research we have on the tests might not provide a good indication of what they would find if all young people under the age of 39 were tested.

The review also found that the research on the tests did not report good accuracy. A high percentage of those receiving positive tests will not have a condition that may cause SCD. The reliability of the test also needs to consider the number of people with the condition who would be missed by the screening test. Also, the way the research was done means that it is not possible to estimate the percentage of people who would be affected, but missed by the test.

The treatment

It is important that there is an effective treatment for people found to have a condition by the screening test. This is because screening programmes invite apparently healthy people to be tested. They are unaware that they may be at risk of having a disease or condition. The screening programme must be able to offer a way of treating, preventing or managing the condition when it is identified, and this should be based on good evidence.

Many heart conditions put an individual at risk of SCD. The review did not find any research on treatments or interventions to prevent SCD in people found by screening. The review did summarise guidelines developed for people at high risk. The guidelines provided advice on how to manage some of the heart conditions. Unfortunately, this advice was not based on good evidence. There was no advice in the guidelines for other heart conditions that may be found by screening.

The review did not find any examples to show the effectiveness of screening programmes in young people on the prevention of SCD. Previous UK NSC reviews have found examples of screening programmes. But these have mainly been in professional athletes. It is not known whether systematic population screening would work to reduce deaths.

Finally, the review was concerned about the effect of receiving an incorrect positive test on people who go for screening. We know very little about this but there are concerns that people may stop participating in sporting activities if they receive an incorrect positive result.

Because of these findings, it was not possible for the review to estimate the balance of benefit and harm that may come from screening all young people under the age of 39. At the moment, there is guidance on testing family members of people at risk of SCD. Effective implementation of this guidance through a targeted screening programme may help prevent SCD in some groups of people who are at high risk.

Supporting documents from the 2019 review

Evidence summary sudden cardiac death (2019)
This document provides the evidence on which the current UK NSC recommendation is based.

UK NSC coversheet & consultation responses SCD (2019)
This document summarises the review process including the public consultation comments.

Review cycle

Date previous review completed: 2019

Next review estimated to be completed: 2023 to 2024.

To see previous evidence reviews, visit the UK NSC archive.

Organisations interested in Sudden cardiac death

These organisations have expressed interest in this recommendation and may submit responses to evidence reviews.

List of organisations

If you think your organisation should be added, please contact us.