Screening for risk of kernicterus not beneficial
The UK National Screening Committee (UK NSC) has published recommendations today (3 August 2016) following its last meeting.
The independent expert committee made 3 recommendations, including recommending against screening for kernicterus.
Kernicterus is a very rare condition in newborn babies which can damage the brain and spinal cord and can be life threatening. It is usually found in babies who have high levels of a substance called bilirubin in their blood. High levels of bilirubin can cause jaundice; signs of jaundice include yellowing of the skin and the whites of the eyes. Much higher levels can cause permanent brain damage.
The committee considered the evidence and found there was insufficient evidence to recommend a national screening programme for the condition.
Dr Anne Mackie, Director of Programmes for the UK National Screening Committee (UK NSC), said:
There is no clear evidence that offering a national screening programme would help find babies at risk of developing kernicterus.
Although tests can measure the level of bilirubin in the blood, it does not make it clear whether the baby would develop kernicterus.
In addition, while current treatment options have been shown to reduce bilirubin levels, it is not known whether these are effective in preventing the condition.
At the same meeting the UK NSC considered the evidence for 2 other conditions and similarly did not recommend introducing screening programmes.
Adolescent Idiopathic Scoliosis (AIS)
AIS is an abnormal curve of the spine that can develop during puberty. Around 2 or 3 people in every 100 have AIS. The committee found that there is no clear guidance about which children should be treated if the condition is found using a screening test. There was also insufficient evidence to suggest that early treatment based on screening tests improved outcomes for the child when compared with waiting for symptoms.
Toxoplasmosis
Toxoplasmosis is an infection caused by a parasite found in uncooked meats, contaminated soil and cat litter. It is common and generally harmless. Many people with the infection do not get symptoms, while others may have mild flu-like symptoms. A pregnant woman can pass this infection onto her unborn child if she becomes infected for the first time during pregnancy. Some babies will be unaffected; others can develop serious complications to their nervous system, heart, eyes and brain.
The committee concluded that the screening test has a high false positive rate, meaning that many women would be wrongly told their child is at risk. Also current treatment with antibiotics does not seem to prevent the infection being passed on to the baby.
All recommendations made by the committee are based on internationally recognised criteria and a rigorous evidence review and consultation process.
The UK NSC will review all these recommendations again in 3 years as part of its regular evidence review process or earlier if significant new evidence becomes available.
The latest screening recommendations were made at the UK NSC committee meeting on 15 June 2016, the minutes of which are published today (Wednesday 3 August 2016).
Full minutes from the UK NSC meeting in June 2016.
For more information please call the Public Health England screening press office on 0114 201 3068 or email screeningpressoffice@phe.gov.uk.
Background
- The UK National Screening Committee is independent of, but supported by, Public Health England (PHE).
- Detailed summaries of the recommendations for all of the conditions mentioned can be found in the relevant sections of the UK NSC website.
- Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.
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