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GPs face more work as genetic screening expanded to families

An overhaul of the national screening programmes to include genetic testing of patients' relatives will dump the majority of the work on to primary care, GPs have warned.

The National Screening Committee has agreed that all existing and future screening programmes, such as those for bladder and cervical cancer, vascular disease and diabetes, have a 'genetic component' and testing first-degree relatives should be considered.

But GPs warned the move could potentially mean 'millions' of people being screened and GPs lacked the appropriate training and resources to cope with the demand.

Dr Naomi Brecker, medical adviser on genetics to the Department of Health, told Pulse relatives might have to be informed about test results for some genetic conditions.

'If you diagnose a genetic condition, that doesn't stop with the patient in front of you.

'There are implications for all the family around them. None of the current screening programmes systematically searches for relatives.'

Dr David Elliman, chair of the committee's child health screening subgroup, said testing neonates for cystic fibrosis and sickle cell disease were the next priority and GPs needed to be 'aware' of how to counsel patients and deal with the ethics of informing otherwise healthy individuals.

He added: 'The GP is the person parents turn to for information. If a baby has a genetic disease it may mean the parents are carriers and their siblings are carriers. Indirectly you have gained information about them.'

He ruled out testing the entire population ­ 'but it could be more than first-

degree relatives,' he said.

Dr Hilary Harris, a GP in Manchester and a member of the Human Genetics Committee, said managing and recording results of the 'millions' of patients' genetic tests would fall to GPs. 'Whatever it is, whenever it's done, it always comes back to the GP's desk,' she said.

Dr Peter Fellows, chair of the GPC prescribing sub-committee, said GPs would inevitably be involved in giving patients advice on genetic


'There would be workload implications but GPs do not have the skills to give enough genetic counselling,' he added.

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