title: Testing the children: do non-genetic health-care providers differ in their decision to advise genetic presymptomatic testing on minors? A cross-sectional study in five countries in the European Union.
abstract: BACKGROUND
  Within Europe many guidelines exist regarding the genetic testing of minors. Predictive and presymptomatic genetic testing of minors is recommended for disorders for which medical intervention/preventive measures exist, and for which early detection improves future medical health.
  
  
  OBJECTIVE
  This study, which is part of the larger 5th EU-framework "genetic education" (GenEd) study, aimed to evaluate the self-reported responses of nongenetic health-care providers in five different EU countries (Germany, France, Sweden, the United Kingdom, and the Netherlands) when confronted with a parent requesting presymptomatic testing on a minor child for a treatable disease.
  
  
  METHODS
  A cross-sectional study design using postal, structured scenario-based questionnaires that were sent to 8129 general practitioners (GPs) and pediatricians, between July 2004 and October 2004, addressing self-reported management of a genetic case for which early medical intervention during childhood is beneficial, involving a minor.
  
  
  RESULTS
  Most practitioners agreed on testing the oldest child, aged 12 years (81.5% for GPs and 87.2% for pediatricians), and not testing the youngest child, aged 6 months (72.6% for GPs and 61.3% for pediatricians). After multivariate adjustment there were statistical differences between countries in recommending a genetic test for the child at the age of 8 years. Pediatricians in France (50%) and Germany (58%) would recommend a test, whereas in the United Kingdom (22%), Sweden (30%), and the Netherlands (32%) they would not.
  
  
  CONCLUSIONS
  Even though presymptomatic genetic testing in minors is recommended for disorders for which medical intervention exists, EU physicians are uncertain at what age starting to do so in young children.
authors.affiliation: Department of Clinical Genetics, Subdivision of Community Genetics, VU University Medical Center, Amsterdam, The Netherlands. amc.plass@vumc.nl
authors.forename: Anne Marie C
authors.initials: AM
authors.lastname: Plass
authors.forename: Marieke J H
authors.initials: MJ
authors.lastname: Baars
authors.forename: Martina C
authors.initials: MC
authors.lastname: Cornel
authors.forename: Claire
authors.initials: C
authors.lastname: Julian-Reynier
authors.forename: Irmgard
authors.initials: I
authors.lastname: Nippert
authors.forename: Hillary
authors.initials: H
authors.lastname: Harris
authors.forename: Ulf
authors.initials: U
authors.lastname: Kristoffersson
authors.forename: Jörg
authors.initials: J
authors.lastname: Schmidtke
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Anionwu
authors.forename: Caroline
authors.initials: C
authors.lastname: Benjamin
authors.forename: Kirsty
authors.initials: K
authors.lastname: Challen
authors.forename: Rodney
authors.initials: R
authors.lastname: Harris
authors.forename: Leo P
authors.initials: LP
authors.lastname: ten Kate
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D003625:Data Collection; D005060:Europe; D005062:European Union; D005260:Female; D005602:France; D005820:Genetic Testing; D005826:Genetics, Medical / Q000941:ethics*; D005858:Germany; D006801:Humans; D007223:Infant; D008297:Male; D009426:Netherlands; D010821:Physicians, Family; D011364:Professional Practice; D011795:Surveys and Questionnaires; D013548:Sweden; D006113:United Kingdom