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BMJ 2010; 341 doi: (Published 21 October 2010) Cite this as: BMJ 2010;341:c5829

Genetic screening is good for industry, not for public health

Genetic screening of whole populations is unlikely to improve public health any time soon and may even undermine current efforts to prevent diseases caused by obesity, smoking, alcohol, and poor diet, say experts. Many common diseases, such as diabetes, have a genetic element. But screening for risky genes (“risk alleles”) generally adds little or nothing to the predictive power of easier to measure risk factors such as age, sex, body mass index, and lifestyle. Even if it did, few interventions can help prevent disease in those at risk. People don’t always change their behaviour when given genetic information. They just worry more. We know next to nothing about the cost effectiveness of most genetic screening, and less about the damage that might be done by giving people an incomplete and potentially inaccurate measure of their risk.

Genetic screening should be tested disease by disease and population by population, they write. Just like other interventions. Otherwise, we risk being manipulated by alcohol, tobacco, gambling, and food industries who have a lot to gain and nothing to lose from encouraging a focus on bad genes rather than bad products. If the point of genetic screening is to prevent disease, we must ask whether it prevents more disease than population based strategies, such as taxing alcohol and cigarettes, banning trans-fats, regulating gambling, or modifying obesogenic environments. These experts doubt it.

More evidence supporting compression only CPR

Cardiopulmonary resuscitation (CPR) without rescue breathing is emerging as the best strategy for bystanders who witness a cardiac arrest outside hospital. Compression only CPR is easier to teach, learn, and perform. We know it works better than nothing, and a recent meta-analysis of the only three trials suggests it works better than standard CPR too (survival to hospital discharge 14% (211/1500) v 12% (178/1531); risk ratio 1.22, 95% CI 1.01 to 1.46). …

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