Background Although young adults perceive themselves as healthy, the global prevalence of cardiometabolic risk factors, particularly obesity, hypertension and prediabetes, in this population are increasing rapidly. This systematic review sought to explore common screening strategies that have been used to identify high-risk young adults in a university setting.

Methods Searches for studies reporting or evaluating screening programmes in university settings between 2000 and 2023 were conducted in three databases (Medline, CINAHL, and Embase). Reference and citation searching was also undertaken for all papers that met the inclusion criteria. Studies that screened healthy, non-pregnant students aged 18-25 years in a higher education setting, were included. Studies reporting the prevalence of risk factors based on screening or medical record analysis, without describing the screening protocol were excluded. The screening process for study eligibility was conducted by two authors. The Joanna Briggs Institute Critical Appraisal Checklists is the tool for assessing the quality of study. Due to the variability of the included studies the narrative synthesis was used.

Results Database and manual searches identified 1669 unique references. 16 studies met the inclusion criteria after screening and full text assessment. Most of the included studies performed in the USA, one study was included from each of Saudi Arabia, and India. Three screening strategies were identified; course-based, part of admission process, and population-based through multiple on-campus locations. Two studies didn’t provide sufficient information to allow categorization. Screening instruments and tools varied across studies that target multiple health conditions. None of the studies reported the frequency or outcomes of clinical follow-up for the individuals with cardiometabolic risk factors identified by screening. The majority of the studies (n=13) didn’t provide information for students who they not participate in or complete the screening process.

Conclusion This systematic review found that cardio-metabolic risk factors can be screened for in a university setting. However, further studies are needed to explore the effectiveness and cost-effectiveness as well as the feasibility, accessibility, and acceptability of university-based screening programme. The findings of this review will inform planned participatory workshops to co-produce and pilot a university-based prediabetes and T2D screening programme in Saudi Arabia.