Screening for sickle cell trait: the Veterans Administration National Sickle Cell Program

Area of Science:

• Hematology
• Genetics
• Public Health

Background:

• Hemoglobinopathies, including sickle cell disease and related disorders, represent a significant public health concern.
• Early identification and management are crucial for improving patient outcomes.
• The Veterans Administration Sickle Cell Program aimed to address these issues through widespread screening and education.

Purpose of the Study:

• To present the 10-year results of the Veterans Administration Sickle Cell Program.
• To assess the prevalence of sickle cell trait and clinically significant hemoglobinopathies within the screened population.
• To evaluate the program's impact on awareness and diagnostic approaches to hemoglobinopathies.

Main Methods:

• Large-scale screening of 370,250 patients.
• Extensive patient engagement through educational sessions (404,341 attendees) and individual counseling (38,347 participants).
• Analysis of screening data to determine the prevalence of various hemoglobin variants.

Main Results:

• Sickle cell trait detected in 6.4% of patients.
• Hemoglobin C (HbC) trait identified in 1.8% of patients.
• Clinically significant hemoglobinopathies (HbSC disease, sickle cell anemia, sickle beta thalassemia) found in 0.41% of screened individuals.
• Numerous uncommon hemoglobin variants were also identified.

Conclusions:

• The program successfully screened a large veteran population, revealing significant prevalence of sickle cell trait and other hemoglobinopathies.
• The initiative demonstrably enhanced awareness and improved the approach to evaluating hemoglobinopathies.
• The findings underscore the importance of comprehensive screening programs for genetic blood disorders.