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Expanded carrier screening for monogenic disorders: where are we now?
Davit Chokoshvili1, Danya Vears1, Pascal Borry1
1Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
Expanded carrier screening (ECS) tests vary widely in the number of conditions screened and mutation analysis. This heterogeneity raises concerns for reproductive decision-making and highlights the need for standardized development criteria.
Area of Science:
- Genetics
- Reproductive Medicine
- Molecular Diagnostics
Background:
- Expanded carrier screening (ECS) is increasingly popular for prospective parents, offering broad identification of recessive genetic disorders.
- ECS tests are now widely accessible, making a comprehensive understanding of their characteristics crucial.
Purpose of the Study:
- To provide a comprehensive overview of the characteristics of currently available expanded carrier screening (ECS) tests.
- To identify and analyze the landscape of ECS providers and their methodologies.
Main Methods:
- A multi-step approach was used, including online searches and literature reviews.
- Consultations with researchers in the field of ECS were conducted to identify relevant providers.
Main Results:
- In January 2017, 16 ECS providers (13 commercial, 2 hospitals, 1 academic lab) were identified.
- Significant variation exists in the number of conditions screened (41-1792) and mutations analyzed.
- Only three conditions were universally screened; substantial differences were noted in mutation screening and variant interpretation.
Conclusions:
- The observed heterogeneity in ECS panels is concerning for reproductive decision-making.
- There is a critical need for clear, concrete criteria to guide the development of standardized ECS panels.
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