Height screening in the community. The commercialization of growth. The role of the pediatrician.
The availability of unlimited but costly supplies of biosynthetic growth hormone has led to pressure for pharmacologic use (as opposed to replacement therapy in proven deficiency states). Commercial and altruistic motives have converged to promote community height screening among individuals who have been perceived by themselves or parents as short. This does not meet accepted criteria for health screening. Height screening of large populations of children yields few unrecognized medical conditions. If the goal of community screening is to identify abnormally short individuals (less than 3%) who might benefit from growth hormone treatment and if the unproven assumption is correct that stature correlates with success and happiness, then those less likely to appear for screening need to be recruited to avoid elitist domination. The annual cost of such growth promotion would be greater than $10 billion, with no evidence for substantial health benefits. Growth monitoring of all children through improved height measurement in schools and in physicians offices, as part of health supervision, is a more sound community approach than height screening.
Rosenbloom
A L
AL
Department of Pediatrics, JHMHC, Gainesville, FL 32610.
Alves
C
C
Cleveland
W W
WW
Eidson
M
M
Gonzalez-Mendoza
L E
LE
Perez-Rodriquez
J E
JE
Bercu
B B
BB
Diamond
F
F
Root
A
A
Shulman
D
D
D001827:Body Height; D003154:Community Medicine; D006130:Growth Disorders / Q000175:diagnosis*; D013006:Growth Hormone / Q000627:therapeutic use; D006801:Humans; D008403:Mass Screening; D010372:Pediatrics; D010819:Physician's Role
D013006:Growth Hormone