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Neonatal screening for cystic fibrosis in Wisconsin
Insights
Neonatal screening for cystic fibrosis (CF) shows promise, but more data is needed to determine its benefits and risks. Further research will clarify screening efficacy and long-term outcomes for newborns.
Area of Science:
- Biomedical research
- Neonatal screening
- Public health
Background:
- Primary care physician cooperation is crucial for referring patients to cystic fibrosis (CF) centers.
- The study aims to evaluate neonatal screening for CF in Wisconsin.
Purpose of the Study:
- To determine the benefits and potential risks of neonatal screening for cystic fibrosis.
- To gather definitive answers regarding the efficacy of CF screening.
Main Methods:
- Comparing clinical outcomes between screened and control groups.
- Longitudinal follow-up of study patients to document the natural history of CF.
- Investigating the relationship between false positive results and perinatal asphyxia.
Main Results:
- Meaningful clinical comparisons are anticipated by 1990.
- False positive results in screening may be linked to perinatal asphyxia, possibly due to pancreatic ischemia from hypoxia.
- Further data on IRT value decline, psychosocial risks, reproductive effects, and cost-effectiveness are pending.
Conclusions:
- It is premature to decide on the efficacy of statewide CF screening.
- The study must be completed before making conclusive recommendations.
- Long-term patient follow-up is essential for understanding CF's natural history and screening impact.
Abstract:
Primary care physicians have been very cooperative in referring screened patients to the two designated CF centers in Wisconsin--the University of Wisconsin Cystic Fibrosis Center, and the center at the Medical College of Wisconsin in Milwaukee--and their help has made this study possible. By 1990, we anticipate that meaningful clinical comparisons between the screened and control groups will be possible, and at that time we can begin to obtain some definitive answers concerning the benefits and potential risks of neonatal screening for cystic fibrosis. At this time, it would be premature to make a decision concerning the efficacy of screening for cystic fibrosis for the State of Wisconsin. It is very important that the study go to completion before making conclusive recommendations. We are eager to meticulously document the natural history of CF by following study patients for a long time. Answers to questions concerning rate of decline of the IRT value in true positives, psychosocial risks of screening to true positives, effect on future reproductive plans, and the cost effectiveness of the screening program will not be available for at least two more years. False positive IRT results seem to be related to perinatal asphyxia. We postulate the mechanism is ischemia in the pancreas related to hypoxia during the perinatal period leading to transient release of trypsin from the pancreas into the bloodstream. Decline of the IRT result over time is of great interest because a repeat blood sampling approach would hopefully eliminate several false positives.(ABSTRACT TRUNCATED AT 250 WORDS)