Measuring paternal discrepancy and its public health consequences.

Area of Science:

• Forensic genetics
• Public health
• Behavioral science

Background:

• Paternal discrepancy (PD) is the identification of a biological father different from the one believed to be.
• Existing literature presents highly variable PD rates, ranging from 0.8% to 30% across studies.

Purpose of the Study:

• To review published evidence on the prevalence of paternal discrepancy.
• To examine the public health consequences associated with both the identification and non-identification of PD.
• To identify demographic and social factors associated with an increased risk of PD.

Main Methods:

• Systematic review of published literature on paternal discrepancy.
• Analysis of genetic and behavioral studies to identify risk factors.
• Evaluation of public health implications based on existing evidence.

Main Results:

• Median PD rate across 17 studies was 3.7%, with a wide range (0.8%–30%).
• Higher risk of PD is associated with younger conception age, socioeconomic deprivation, non-marital relationships, and specific cultural contexts.
• Consequences of PD disclosure include family disruption and violence; non-disclosure leads to genetic misinformation and paternal uncertainty.

Conclusions:

• Increased use of DNA testing in clinical and judicial settings will likely lead to more PD identifications.
• The implications of PD for genetic information in healthcare, insurance, and personal decisions necessitate urgent attention.
• There is a critical need for guidelines on the ethical and effective disclosure of paternal discrepancy.