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Last Updated: Wednesday, 25 June, 2003, 13:47 GMT 14:47 UK
Could DNA screening work?
By Ray Dunne
BBC News Online health staff

A few drops of blood could provide the genetic codes
Just a few drops of blood could soon revolutionise the way healthcare is delivered across Britain.

The government has suggested that at some point in the future every newborn baby could leave hospital with details of their unique genetic code.

This code could provide them, their parents and their doctors with a relatively clear vision of how their health will develop in the years ahead.

It could identify those at risk of developing serious diseases like cancer and heart disease and, even perhaps, pinpoint those most likely to suffer from mental illness.

The technology is developing rapidly but we are not there yet
Professor John Burn,
University of Newcastle

All of this will, of course, pass the newborn baby by. They will have no memory of how nurses pricked their heel with a sharp needle to get just a few droplets of blood.

They will have no knowledge of how laboratory technicians analysed their blood to decipher their unique genetic code.

They will be oblivious to how their parents reacted when told that their newborn child may or may not be susceptible to any one of the thousands of conditions that may be caused by genetic mutations.

But in a few years, they could be perfectly able to explain why they are taking medication to reduce their risks of developing high blood pressure or high cholesterol and why they are more susceptible to heart disease compared to their classmates.

Under consideration

This scenario is still a long way off but it is something the government is considering.

Ministers have asked the Human Genetics Commission to examine how and if such tests should be introduced. Its experts have been asked to report back by the end of 2004.

Under the proposals, a baby's genetic information could be stored securely on new electronic patient records.

We really don't see how this could help improve people's health.
Dr Sue Mayer,
GeneWatch UK

Doctors could use that information to decide whether or not they should be prescribed "preventive" medication to reduce their risks of developing certain conditions.

They could undergo treatment to correct their defective genes or, at the very least, could have regular check-ups to ensure that if they develop a particular disease it is spotted early when the chances of curing it are highest.

The scheme would be voluntary and people would have the right to have their genetic information taken off their medical notes at any time.

At the moment, doctors already screen newborn babies for a range of serious conditions, including some caused by genetic mutations such as Cystic Fibrosis.

The current policy is only to screen for those conditions for which treatments are available. For that reason, the government's proposals are controversial.

"We could have a situation where people are told they are at risk of a particular disorder and that there is currently no treatment for it," says Dr David Goudie, a consultant geneticist at Ninewells Hospital in Dundee.

"This is not helpful for people and for that reason I would not really be in favour of it."

Technological advance

Full-scale DNA screening is some way off. The technology needed to carry out widescale gene sequencing of newborn babies does not yet exist.

"The technology is developing rapidly but we are not there yet," says John Burn, professor of clinical genetics at Newcastle University and a member of the Human Genetics Commission.

"It is still too expensive to roll out screening tests for the whole population. But we are going to see these technical barriers disappear.
We must not overemphasise the impact of genes on health outcomes
Charlotte Augst,
CancerBACUP

"It could be 10 years from now. It could be much sooner.

"That is why we need to discuss the social barriers, the safeguards and constraints, now," he says.

Certainly, the prospect of being able to identify people at risk of developing certain conditions will change the face of medicine.

Dr Adrian Thrasher, is head of the team at the Institute of Child Health in London which conducted Britain's first successful gene therapy trials.

"Screening newborn babies opens up the possibility of being able to pick up diseases early," he says.

"We need to start looking at genes as medicines," he says. "We are treating cells that are defective in the first place. This improves our armoury against diseases."

Others are less sure. There is already some concern about the implications of being able to provide newborn babies with information on their susceptibility to a range of serious conditions.

"Who will have access to this information?" asks Dr Sue Mayer, director of GeneWatch UK.

"We don't have safeguards to prevent employers or insurers from asking for this information."

She and others are concerned that these tests could raise patient expectations to unrealistic levels.

"We must not overemphasise the impact of genes on health outcomes," says Charlotte Augst, of UK charity CancerBACUP.

"It is not all in our genes - lifestyle factors like smoking and obesity, but also socio-economic factors linked to income and diet are far more important for the majority of cancers."

GeneWatch UK is firmly against widescale DNA screening of newborn babies.

"We want the Human Genetics Commission to look at this issue and to rule it out," says Dr Mayer.

"We really don't see how this could help improve people's health. We really don't.

"Science would have to advance enormously for it to have any real benefits."


SEE ALSO:
Millions for genetic technology
24 Jun 03  |  Health
Q&A: Gene therapy
24 Jun 03  |  Health
Clinging to hope for baby Ella
24 Jun 03  |  Politics


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