Abstract
OBJECTIVE: To determine the uptake and acceptability of cystic fibrosis (CF) carrier testing when offered to women at the first antenatal booking appointment by their general practitioner. SETTING: Eight-general practices in the north west region with a combined patient list size of 42000. DESIGN: Offer of carrier screening at first antenatal booking appointment to pregnant women below 14 weeks' gestation; women accepting were alternately allocated to either couple testing (with full disclosure) or stepwise testing: SUBJECTS: Six hundred and twenty three women were offered CF carrier testing. MAIN OUTCOME MEASURES: (1) Acceptance of the offer of CF carrier testing. (2) Acceptability of the test to women following screening, evaluated through (i) postal questionnaire, (ii) semistructured interview. RESULTS: Five hundred and twenty-nine (84.9%) women accepted the test; the level of uptake varied across the eight practices (range 11-99%). In 26/249 (10%) couple tests no paternal sample was provided. When asked what had influenced their decision to be tested, 59/377 (16%) women did not refer to CF in their answers and six (2%) said that they did not feel they could refuse the test. After receiving their results, 368/379 (97%) women felt that they had made the right decision to be tested, but two carriers and three non-carriers had felt unhappy about testing. Couple testing with full disclosure was associated with lower anxiety levels two weeks after receiving the result for the pregnancy than stepwise testing and 82/278 (29%) non-carriers believed that they had no residual risk in relation to CF. CONCLUSIONS: The response from women accepting CF carrier testing was largely positive but a minority of women expressed concern about the test and the way it was offered and a substantial proportion of women were falsely reassured by their "negative" result. Higher levels of acceptance tended to occur in the practices which offered the test there and then rather than giving couples more time to decide about testing. Some women appeared to have accepted the test because of a belief in the importance of testing in pregnancy rather than because of the disease in question.
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Selected References
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- Bekker H., Modell M., Denniss G., Silver A., Mathew C., Bobrow M., Marteau T. Uptake of cystic fibrosis testing in primary care: supply push or demand pull? BMJ. 1993 Jun 12;306(6892):1584–1586. doi: 10.1136/bmj.306.6892.1584. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harris H., Scotcher D., Hartley N., Wallace A., Craufurd D., Harris R. Cystic fibrosis carrier testing in early pregnancy by general practitioners. BMJ. 1993 Jun 12;306(6892):1580–1583. doi: 10.1136/bmj.306.6892.1580. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harris H., Scotcher D., Hartley N., Wallace A., Craufurd D., Harris R. Pilot study of the acceptability of cystic fibrosis carrier testing during routine antenatal consultations in general practice. Br J Gen Pract. 1996 Apr;46(405):225–227. [PMC free article] [PubMed] [Google Scholar]
- Kerem B., Rommens J. M., Buchanan J. A., Markiewicz D., Cox T. K., Chakravarti A., Buchwald M., Tsui L. C. Identification of the cystic fibrosis gene: genetic analysis. Science. 1989 Sep 8;245(4922):1073–1080. doi: 10.1126/science.2570460. [DOI] [PubMed] [Google Scholar]
- Marteau T. M., Cook R., Kidd J., Michie S., Johnston M., Slack J., Shaw R. W. The psychological effects of false-positive results in prenatal screening for fetal abnormality: a prospective study. Prenat Diagn. 1992 Mar;12(3):205–214. doi: 10.1002/pd.1970120309. [DOI] [PubMed] [Google Scholar]
- Mennie M. E., Compton M. E., Gilfillan A., Liston W. A., Pullen I., Whyte D. A., Brock D. J. Prenatal screening for cystic fibrosis: psychological effects on carriers and their partners. J Med Genet. 1993 Jul;30(7):543–548. doi: 10.1136/jmg.30.7.543. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Miedzybrodzka Z. H., Hall M. H., Mollison J., Templeton A., Russell I. T., Dean J. C., Kelly K. F., Marteau T. M., Haites N. E. Antenatal screening for carriers of cystic fibrosis: randomised trial of stepwise v couple screening. BMJ. 1995 Feb 11;310(6976):353–357. doi: 10.1136/bmj.310.6976.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Raeburn J. A. Screening for carriers of cystic fibrosis. Screening before pregnancy is needed. BMJ. 1994 Nov 26;309(6966):1428–1429. doi: 10.1136/bmj.309.6966.1428. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Riordan J. R., Rommens J. M., Kerem B., Alon N., Rozmahel R., Grzelczak Z., Zielenski J., Lok S., Plavsic N., Chou J. L. Identification of the cystic fibrosis gene: cloning and characterization of complementary DNA. Science. 1989 Sep 8;245(4922):1066–1073. doi: 10.1126/science.2475911. [DOI] [PubMed] [Google Scholar]
- Rommens J. M., Iannuzzi M. C., Kerem B., Drumm M. L., Melmer G., Dean M., Rozmahel R., Cole J. L., Kennedy D., Hidaka N. Identification of the cystic fibrosis gene: chromosome walking and jumping. Science. 1989 Sep 8;245(4922):1059–1065. doi: 10.1126/science.2772657. [DOI] [PubMed] [Google Scholar]
- Sjögren B., Uddenberg N. Decision making during the prenatal diagnostic procedure. A questionnaire and interview study of 211 women participating in prenatal diagnosis. Prenat Diagn. 1988 May;8(4):263–273. doi: 10.1002/pd.1970080404. [DOI] [PubMed] [Google Scholar]
- Wald N. J. Couple screening for cystic fibrosis. Lancet. 1991 Nov 23;338(8778):1318–1319. doi: 10.1016/0140-6736(91)92605-2. [DOI] [PubMed] [Google Scholar]
- Watson E. K., Mayall E., Chapple J., Dalziel M., Harrington K., Williams C., Williamson R. Screening for carriers of cystic fibrosis through primary health care services. BMJ. 1991 Aug 31;303(6801):504–507. doi: 10.1136/bmj.303.6801.504. [DOI] [PMC free article] [PubMed] [Google Scholar]
