Universal capillary screening for chronic autoimmune, metabolic and cardiovascular diseases: feasibility and acceptability of the UNISCREEN study.

Abstract

Background: UNISCREEN is a general population study aiming at evaluating feasibility and acceptability of universal screening for chronic autoimmune (type 1 diabetes and celiac disease) and metabolic/cardiovascular diseases (dysglycemia, type 2 diabetes, dyslipidemia, hypertension) across all age groups using capillary blood sampling by fingerprick to measure disease risk markers.

Methods: UNISCREEN was conducted in the Cantalupo fraction, Cerro Maggiore, Milan, Italy, counting 3,061 inhabitants between 1 and 100 years of age. Participation was voluntary, following a public call. Participants were invited to respond to feasibility and acceptability questionnaires immediately before and after the screening procedures, which included the following: capillary blood drawing for immediate measurement of metabolic parameters (glucose, glycated hemoglobin, total-, HDL- and calculated LDL-cholesterol, triglycerides) and late autoantibody assays; blood pressure measurement; brief consultation with a physician providing feed-back on immediate results and health recommendations. The study was registered as ClinicalTrials.gov NCT05841719.

Results: The study included 1,535 participants (50.1% of local population). A single fingerprick was sufficient for all measurements in 47.1% of cases, while up to two were necessary in 86.9% of cases. Complete glucose and lipid panels were obtained in 1382 participants (90.0%). Sufficient serum for late autoantibody testing was obtained in 99.7% of participants. The questionnaires showed overall satisfaction, with over 90% of participants considering capillary sampling simple and practical, and preferring it to venous sampling. Before screening, 24.0% adults and 31.7% children's parents were worried about the possibility of being diagnosed or identified as being at risk; worries decreased to 21.3 and 23.4%, respectively, after medical consultation. The immediacy of some result communication possibly contributed to reducing the anticipatory anxiety.

Conclusion: The UNISCREEN study shows that universal screening for chronic autoimmune, metabolic and cardiovascular diseases in the general population using capillary blood testing is feasible and acceptable.