Control of hereditary diseases. Report of a WHO Scientific Group

Possibilities for treating--or, ideally, avoiding--hereditary diseases have increased enormously with the rapid and radical developments in the field of molecular biology. This report of a WHO Scientific Group deals first with the human genome and the genetic basis of disease, then continues with a review of the epidemiology of genetic disorders and the role of genetic predisposition in various common conditions, including coronary heart disease, cancer, asthma, diabetes and mental disorders. In discussing prevention, the report considers both genetic family studies and population screening. It is pointed out that the cost-benefit ratio of providing genetic services is extremely favourable, and prevention is often far cheaper than treatment. An entire section of the report is devoted to genetic counseling, which is particularly important because of the psychological impact of knowledge of genetic risk and the difficult decisions that often face individuals identified as being at risk. Obstetric aspects of prenatal diagnosis are considered; techniques discussed include ultrasound scanning, chorionic villus and fetal blood sampling, and amniocentesis. Organization of genetic services is reviewed, and the ethical, social and legal aspects of genetic technology in medicine are examined. The report concludes with a summary of the Scientific Group's recommendations.