Why screen for cystic fibrosis? A clinician's view.
Cystic fibrosis (CF) is relatively common, serious, and causes progressive lung damage. Clinical diagnosis may be delayed until lung damage has occurred, and infection may start as early as six weeks of life. A well organised screening programme should identify the great majority of affected infants within the first three weeks after birth, which leaves a small time window during which effective preventive treatment and surveillance may be instituted. Active treatment, whether for screened or unscreened infants, improves clinical status and long-term survival of CF patients. It is anticipated that new treatments will become available within the next few years, and these will clearly give maximal benefit to young infants if instituted before lung damage is evident. In addition to any hypothetical effects on morbidity and survival, pre-symptomatic diagnosis greatly improves the doctor-parent relationship. Economic arguments may be distorted, but, at best, screening is cost-beneficial, and, at worst, it is cost-neutral. The overwhelming majority of CF professionals and parents universally support neonatal screening, so the onus is therefore on those who oppose screening to prove that their approach offers a superior strategy.
Dodge
J A
JA
Department of Child Health, Singleton Hospital, Swansea, Wales, UK. J.A.Dodge@btinternet.com
D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000458:organization & administration*; D011379:Prognosis; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D013997:Time Factors; D006113:United Kingdom