First French study relative to preconception genetic testing: 1500 general population participants' opinion.


Journal

Orphanet journal of rare diseases
ISSN: 1750-1172
Titre abrégé: Orphanet J Rare Dis
Pays: England
ID NLM: 101266602

Informations de publication

Date de publication:
12 03 2021
Historique:
received: 08 04 2020
accepted: 18 02 2021
entrez: 13 3 2021
pubmed: 14 3 2021
medline: 22 6 2021
Statut: epublish

Résumé

Until very recently, preconception genetic testing was only conducted in particular communities, ethnic groups or families for which an increased risk of genetic disease was identified. To detect in general population a risk for a couple to have a child affected by a rare, recessive or X-linked, genetic disease, carrier screening is proposed in several countries. We aimed to determine the current public opinion relative to this approach in France, using either a printed or web-based questionnaire. Among the 1568 participants, 91% are favorable to preconception genetic tests and 57% declare to be willing to have the screening if the latter is available. A medical prescription by a family doctor or a gynecologist would be the best way to propose the test for 73%, with a reimbursement from the social security insurance. However, 19% declare not to be willing to use the test because of their ethic or moral convictions, and the fear that the outcome would question the pregnancy. Otherwise, most participants consider that the test is a medical progress despite the risk of an increased medicalization of the pregnancy. This first study in France highlights a global favorable opinion for the preconception genetic carrier testing under a medical prescription and a reimbursement by social security insurance. Our results emphasize as well the complex concerns underpinned by the use of this screening strategy. Therefore, the ethical issues related to these tests include the risk of eugenic drift mentioned by more than half of the participants.

Sections du résumé

BACKGROUND
Until very recently, preconception genetic testing was only conducted in particular communities, ethnic groups or families for which an increased risk of genetic disease was identified. To detect in general population a risk for a couple to have a child affected by a rare, recessive or X-linked, genetic disease, carrier screening is proposed in several countries. We aimed to determine the current public opinion relative to this approach in France, using either a printed or web-based questionnaire.
RESULTS
Among the 1568 participants, 91% are favorable to preconception genetic tests and 57% declare to be willing to have the screening if the latter is available. A medical prescription by a family doctor or a gynecologist would be the best way to propose the test for 73%, with a reimbursement from the social security insurance. However, 19% declare not to be willing to use the test because of their ethic or moral convictions, and the fear that the outcome would question the pregnancy. Otherwise, most participants consider that the test is a medical progress despite the risk of an increased medicalization of the pregnancy.
CONCLUSION
This first study in France highlights a global favorable opinion for the preconception genetic carrier testing under a medical prescription and a reimbursement by social security insurance. Our results emphasize as well the complex concerns underpinned by the use of this screening strategy. Therefore, the ethical issues related to these tests include the risk of eugenic drift mentioned by more than half of the participants.

Identifiants

pubmed: 33712027
doi: 10.1186/s13023-021-01754-z
pii: 10.1186/s13023-021-01754-z
pmc: PMC7955630
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

130

Références

J Genet Couns. 2017 Aug;26(4):690-696
pubmed: 27796679
Best Pract Res Clin Obstet Gynaecol. 2017 Jul;42:2-10
pubmed: 28533154
Eur J Hum Genet. 2012 Jul;20(7):715-21
pubmed: 22274578
PLoS One. 2018 Jul 18;13(7):e0200139
pubmed: 30020962
Bioethics. 2019 Jun;33(5):568-576
pubmed: 30734373
Genet Test Mol Biomarkers. 2017 Mar;21(3):195-201
pubmed: 28306397
Clin Genet. 2018 May;93(5):962-971
pubmed: 29293279
Public Health Genomics. 2011;14(2):85-93
pubmed: 20299772
Am J Med Genet A. 2016 Aug;170(8):2052-9
pubmed: 27150953
J Community Genet. 2012 Jul;3(3):221-8
pubmed: 22205578
Am J Public Health. 2014 Jan;104(1):17-22
pubmed: 24228653
J Genet Couns. 2015 Dec;24(6):987-1000
pubmed: 25925605
Twin Res Hum Genet. 2013 Apr;16(2):601-7
pubmed: 23331496
Eur J Hum Genet. 2019 May;27(5):691-700
pubmed: 30742054
Syst Rev. 2016 Apr 07;5:54
pubmed: 27055820
Eur J Hum Genet. 2016 Feb;24(2):171-7
pubmed: 25966636
Eur J Hum Genet. 2016 Jun;24(6):e1-e12
pubmed: 26980105
Contemp Clin Trials. 2017 Feb;53:100-105
pubmed: 27940182
Eur J Hum Genet. 2016 Oct;24(10):1417-23
pubmed: 27165008
Mayo Clin Proc. 2001 Aug;76(8):777-83
pubmed: 11499815
Hum Reprod. 2013 Jun;28(6):1725-30
pubmed: 23589535
Life Sci Soc Policy. 2015;11:4
pubmed: 26085310
Fertil Steril. 2012 Feb;97(2):407-13
pubmed: 22137493
Ups J Med Sci. 2016 Nov;121(4):295-298
pubmed: 27388477

Auteurs

Valérie Bonneau (V)

Département de Médecine Générale, Université de Nantes, 44000, Nantes, France.
USR 3491 Maison Des Sciences de L'Homme Ange Guepin, 44000, Nantes, France.

Mathilde Nizon (M)

Service de Génétique Médicale, CHU Nantes, 9 quai Moncousu, 44093, Nantes Cedex 1, France.

Xenia Latypova (X)

Service de Génétique Médicale, CHU Nantes, 9 quai Moncousu, 44093, Nantes Cedex 1, France.

Aurélie Gaultier (A)

Plateforme de Méthodologie Et de Biostatistique, Centre Hospitalier Universitaire de Nantes, Nantes, France.

Eugénie Hoarau (E)

Département de Médecine Générale, Université de Nantes, 44000, Nantes, France.
USR 3491 Maison Des Sciences de L'Homme Ange Guepin, 44000, Nantes, France.

Stéphane Bézieau (S)

Service de Génétique Médicale, CHU Nantes, 9 quai Moncousu, 44093, Nantes Cedex 1, France.

Guy Minguet (G)

Mines-Nantes School, 44300, Nantes, France.

Mauro Turrini (M)

Université de Nantes, Droit et Changement Social UMR 6297, Maison Des Sciences de L'Homme Ange Guépin, Nantes, France.

Maud Jourdain (M)

Département de Médecine Générale, Université de Nantes, 44000, Nantes, France.
USR 3491 Maison Des Sciences de L'Homme Ange Guepin, 44000, Nantes, France.

Bertrand Isidor (B)

Service de Génétique Médicale, CHU Nantes, 9 quai Moncousu, 44093, Nantes Cedex 1, France. bertrand.isidor@chu-nantes.fr.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH