Making a Case for Expanding Genetic Screening to Entire Populations

By Kirell Lakhman

Ever wonder what it would be like to extend genetic screening to entire populations in order to identify genetic susceptibilities that may help hasten diagnostics later in patients' lives, improve their family-planning decisions before conceiving a child, and improve disease prevention?

If your mind has drifted now and then in that direction, a new study may support your thinking.

Current approaches to genetic screening include newborn screening to ID infants "who would benefit from early treatment," targeted reproductive genetic screening "to assist reproductive decision making," and one-off family-history assessment to "identify individuals who would benefit from additional prevention measures," according to the paper, which appears in the current Epidemiological Reviews (Epub ahead of print).

However, genetic screening "has always included atypical element-information relevant to reproductive decisions" thanks to new technologies that offer "increasingly comprehensive" ways to identify genetic conditions and susceptibilities on a broader level.

According to the paper, tests based on these technologies are "generating a different approach to screening" — population-based genetic-screening — "that seeks to inform individuals about all of their genetic traits and susceptibilities for purposes that incorporate rapid diagnosis, family planning, and expediting of research, as well as the traditional screening goal of improving prevention."

However, there may be some roadblocks: Using these tests for this broad indication "will increase the challenges" that already appear as part of other kinds of genetic-screening programs, such as those for certain cancer, including false-positive and "ambiguous" test results, overdiagnosis, and "incidental findings," the paper says.

Moreover, the paper's abstract says using population-based genetic-screening programs "requires careful deliberation on the part of all concerned" — genomic researchers, clinicians, public-health officials, payors, and "especially those who will be the recipients of this novel screening approach."

But on the bright side, the stage appears to already have been set at least to address when genetic tests can be used on entire populations, but it may not be right now: Their use for these indications "requires further empiric research," according to the paper.


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