Better screening needed for sickle cell and thalassaemia

BMJ 2000; 321 doi: (Published 29 July 2000) Cite this as: BMJ 2000;321:260
  1. Jenny Blythe
  1. BMJ

    Universal antenatal screening for sickle cell disease and thalassaemia may be cost effective in some areas of the United Kingdom, says a report from the Wessex Institute for Health Research and Development.

    Universal antenatal and neonatal screening was previously recommended in areas in which 15% or more of the population is from ethnic minority groups. Current screening schemes are described by the institute as “patchy” and “unstructured.” According to its study, screening and counselling would be self financing in areas with a 1% ethnic minority population if 25% of that group carry the b thalassaemia trait.

    The study also suggests that the programme would benefit from partnerships between health authorities. An improvement in systematic collection of data would provide more information about screening uptake.

    As well as being cost effective, screening programmes allow women to make more informed decisions about their pregnancy, as they incorporate detection of a carrier parent, genetic counselling, and the choice of prenatal diagnosis.

    Outcome measures of cost effectiveness included rates of prenatal diagnosis and termination of affected pregnancies. In the study, 80% of b thalassaemia births were prevented by the antenatal screening, as were 16% of sickle cell births.

    Screening for Sickle Cell Disease and Thalassaemia: A Systematic Review with Supplementary Research can be obtained by fax from 023 8059 5639 or accessed at

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