Skip to main content
American Journal of Human Genetics logoLink to American Journal of Human Genetics
. 1996 Mar;58(3):617–627.

Lack of interest by nonpregnant couples in population-based cystic fibrosis carrier screening.

E W Clayton 1, V L Hannig 1, J P Pfotenhauer 1, R A Parker 1, P W Campbell 3rd 1, J A Phillips 3rd 1
PMCID: PMC1914565  PMID: 8644721

Abstract

We used signs and letters to offer free cystic fibrosis (CF) carrier screening to nonpregnant adults in stable relationships who visited numerous clinical and nonclinical sites in Nashville. A total of 179 individuals (<<1% of those eligible) elected to be tested. To understand this observation, we used questionnaires to assess individuals' attitudes about genetic testing in general and about CF carrier screening in particular (n=873). Participants expressed conflicting views about carrier screening. More than 90% of people thought that genetic testing should at least be available. Most respondents said that the views of their partners and physicians were important in their decision making, and most believed that these others favored genetic testing. Yet, more than two-thirds indicated that such factors as insurability, being "at risk," what they would need to learn, abortion, and religious beliefs were important in their decision making, opinions that mitigated against genetic testing. In particular, one-third feared that carriers would lose their health insurance, one-quarter said that they would have been more interested had they been able to provide DNA by buccal swab rather than by finger stick, and less than one-sixth believed that genetic testing was meddling in God's plan. In the face of both the low level of use of free CF carrier screening by nonpregnant couples when it was not offered in person by health-care professionals and the wide variety of concerns demonstrated, we believe that clinicians should not routinely offer carrier screening to nonpregnant individuals who do not have a family history of CF.

Full text

PDF
625

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Asch D. A., Patton J. P., Hershey J. C., Mennuti M. T. Reporting the results of cystic fibrosis carrier screening. Am J Obstet Gynecol. 1993 Jan;168(1 Pt 1):1–6. doi: 10.1016/s0002-9378(12)90875-3. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Billings P. R., Kohn M. A., de Cuevas M., Beckwith J., Alper J. S., Natowicz M. R. Discrimination as a consequence of genetic testing. Am J Hum Genet. 1992 Mar;50(3):476–482. [PMC free article] [PubMed] [Google Scholar]
  4. Botkin J. R., Alemagno S. Carrier screening for cystic fibrosis: a pilot study of the attitudes of pregnant women. Am J Public Health. 1992 May;82(5):723–725. doi: 10.2105/ajph.82.5.723. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Caskey C. T., Kaback M. M., Beaudet A. L. The American Society of Human Genetics statement on cystic fibrosis screening. Am J Hum Genet. 1990 Feb;46(2):393–393. [PMC free article] [PubMed] [Google Scholar]
  6. Clayton E. W., Hannig V. L., Pfotenhauer J. P., Parker R. A., Campbell P. W., 3rd, Phillips J. A., 3rd Teaching about cystic fibrosis carrier screening by using written and video information. Am J Hum Genet. 1995 Jul;57(1):171–181. [PMC free article] [PubMed] [Google Scholar]
  7. Colten H. R. Screening for cystic fibrosis; public policy and personal choices. N Engl J Med. 1990 Feb 1;322(5):328–329. doi: 10.1056/NEJM199002013220510. [DOI] [PubMed] [Google Scholar]
  8. Faden R. R., Tambor E. S., Chase G. A., Geller G., Hofman K. J., Holtzman N. A. Attitudes of physicians and genetics professionals toward cystic fibrosis carrier screening. Am J Med Genet. 1994 Mar 1;50(1):1–11. doi: 10.1002/ajmg.1320500102. [DOI] [PubMed] [Google Scholar]
  9. Gilbert F. Is population screening for cystic fibrosis appropriate now? Am J Hum Genet. 1990 Feb;46(2):394–395. [PMC free article] [PubMed] [Google Scholar]
  10. Kaback M., Lim-Steele J., Dabholkar D., Brown D., Levy N., Zeiger K. Tay-Sachs disease--carrier screening, prenatal diagnosis, and the molecular era. An international perspective, 1970 to 1993. The International TSD Data Collection Network. JAMA. 1993 Nov 17;270(19):2307–2315. [PubMed] [Google Scholar]
  11. Lippman A. Prenatal genetic testing and screening: constructing needs and reinforcing inequities. Am J Law Med. 1991;17(1-2):15–50. [PubMed] [Google Scholar]
  12. Mennie M. E., Gilfillan A., Compton M., Curtis L., Liston W. A., Pullen I., Whyte D. A., Brock D. J. Prenatal screening for cystic fibrosis. Lancet. 1992 Jul 25;340(8813):214–216. doi: 10.1016/0140-6736(92)90476-j. [DOI] [PubMed] [Google Scholar]
  13. Natowicz M. R., Alper J. K., Alper J. S. Genetic discrimination and the law. Am J Hum Genet. 1992 Mar;50(3):465–475. [PMC free article] [PubMed] [Google Scholar]
  14. Tambor E. S., Bernhardt B. A., Chase G. A., Faden R. R., Geller G., Hofman K. J., Holtzman N. A. Offering cystic fibrosis carrier screening to an HMO population: factors associated with utilization. Am J Hum Genet. 1994 Oct;55(4):626–637. [PMC free article] [PubMed] [Google Scholar]
  15. 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]
  16. 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]
  17. Wertz D. C., Janes S. R., Rosenfield J. M., Erbe R. W. Attitudes toward the prenatal diagnosis of cystic fibrosis: factors in decision making among affected families. Am J Hum Genet. 1992 May;50(5):1077–1085. [PMC free article] [PubMed] [Google Scholar]
  18. Wilfond Benjamin S., Fost Norman. The cystic fibrosis gene: medical and social implications for heterozygote detection. JAMA. 1990 May 23;263(10):2777–2783. [PubMed] [Google Scholar]

Articles from American Journal of Human Genetics are provided here courtesy of American Society of Human Genetics

RESOURCES