[Iron overload and public health]

Genetic hemochromatosis, due to its frequency (about 300,000 cases in France) and to its severity, must be considered as a public health burden. Its curability--insofar as its diagnosis has been made early--and the disposal of non invasive and reliable phenotypic (transferrin saturation) and genotypic (HFE C282Y mutation) tests make its diagnosis easy. Thus, diagnosis faced with early clinical and biological symptoms must be promulgated as screening in probant families. General screening is still hampered by ethical and socio-economic obstacles, but should be evaluated in large prospective studies. Otherwise, the recently described insulin resistance-associated liver iron overload syndrome might account for epidemiological associations that have been reported between increased body iron stores and cancerous, cardio-vascular and hepatic disorders. This might extend markedly the impact of iron overload in public health and lead to broaden screening and prevention to all iron overload conditions.