Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
School of Life Sciences, University of Warwick, Coventry, UK.
Health Expect. 2018 Feb;21(1):201-211. doi: 10.1111/hex.12602. Epub 2017 Jul 13.
Autosomal recessive conditions, while individually rare, are a significant health burden with limited treatment options. Population carrier screening has been suggested as a means of tackling them. Little is known, however, about the attitudes of the general public towards such carrier screening and still less about the views of people living with candidate genetic diseases. Here, we focus on the role that such experience has on screening attitudes by comparing views towards screening of people with and without prior experience of the monogenetic disorder, Spinal Muscular Atrophy.
An exploratory sequential mixed methods design was adopted. In-depth qualitative interviews were used to develop two surveys. The surveys addressed attitudes towards carrier screening (pre-conceptual and prenatal) for SMA.
337 participants with SMA experience completed the SMA Screening Survey (UK) and 336 participants with no prior experience of SMA completed the UK GenPop Survey, an amended version of the SMA Screening Survey (UK).
The majority of both cohorts were in favour of pre-conception and prenatal carrier screening, however people with experience of type II SMA were least likely to support either. Key differences emerged around perceptions of SMA, with those without SMA experience taking a dimmer view of the condition than those with.
This study underscores the significance of prior experience with the condition to screening attitudes. It highlights the need for accurate and high-quality educational resources to support any future carrier screening programmes, that particularly in relation to rare genetic disorders like SMA that will fall outside the remit of everyday experience for the majority of the population.
常染色体隐性疾病虽然每个疾病都很少见,但由于治疗方法有限,它们对健康造成了重大负担。有人建议进行常染色体隐性疾病携带者筛查,以解决这些问题。然而,人们对普通公众对这种携带者筛查的态度知之甚少,对患有候选遗传疾病的人的看法则更少。在这里,我们通过比较有和没有脊髓性肌萎缩症(SMA)单基因疾病既往史的人群对筛查的看法,关注这种经历对筛查态度的作用。
采用探索性顺序混合方法设计。深入的定性访谈用于开发两份调查。这些调查涉及对 SMA 携带者筛查(孕前和产前)的态度。
337 名有 SMA 经验的参与者完成了 SMA 筛查调查(英国),336 名无 SMA 既往史的参与者完成了英国普通人群调查,这是 SMA 筛查调查(英国)的修改版。
两个队列的大多数人都赞成孕前和产前携带者筛查,但有 II 型 SMA 既往史的人最不可能支持任何一种筛查。对 SMA 的看法存在明显差异,没有 SMA 经验的人对该疾病的看法比有 SMA 经验的人更为暗淡。
本研究强调了既往疾病经验对筛查态度的重要性。它强调了需要有准确和高质量的教育资源来支持任何未来的携带者筛查计划,特别是对于 SMA 等罕见遗传疾病,这将超出大多数人日常经验的范围。