A national screening policy for sickle cell disease and thalassaemia major for the United Kingdom

Questions are left after two evidence based reports

Sickle cell disease and thalassaemia major are serious health problems for inner city populations in Britain, but services are inconsistent and policy guidance is unclear1^–4 The NHS Health Technology Assessment Programme commissioned two systematic reviews to identify the objectives of the screening programmes and to determine whether, and in which populations, screening using haematological tests should be either selective or universal. The decision on who to screen in areas where not everyone is tested is based on questions to identify ethnic origin.

The two reports provide similar estimates for the burden of disease. One estimated that each year 28–60 fetuses are conceived and 17 infants are born with thalassaemia and that 133–238 fetuses are conceived and 160 infants are born with sickle cell disease in England.5 The other report gave estimates for the United Kingdom of 44 and 171 respectively for conceptions.6

Both reports show that the population at risk has an uneven geographical distribution. For this reason, selective rather than …