Cystic fibrosis should be added to diseases sought in all newborn babies

EDITOR—Wald and Morris's editorial on neonatal screening for cystic fibrosis is a good example of the different viewpoints held by doctors concerned with public health and by clinicians and highlights the need for both groups to have input into health service policy.1 They reviewed papers describing nutritional benefits of neonatal diagnosis of cystic fibrosis 2 3 with extrapolations predicting long term individual health benefits and short to medium term costs of a screening programme. The differences between screened and unscreened patients were small in terms of growth during the first 10 years. Healthcare purchasers are more easily persuaded by short term financial arguments than by long term predictions, particularly when the predictions involve many uncertainties, but clinicians can advance other persuasive arguments in favour of screening newborn babies.

Firstly, for parents to be confronted with the diagnosis of cystic fibrosis in their baby is always unpleasant. The shock can be mitigated by the knowledge that the diagnosis was made early, perhaps even before symptoms were noted; that attempts will be made to prevent or minimise lung damage; and that a programme of expert care is being offered. In contrast, many parents …