The Evolving Landscape of Genetic Carrier Screening: Clinical Considerations and Challenges

Abstract

ABSTRACT Importance Genetic carrier screening is performed to identify carriers of rare genetic diseases. Identification of carriers allows patients to make informed reproductive health choices and can decrease the incidence of genetic disorders with serious medical implications. Objective This review aims to provide an overview of the history of prenatal genetic screening and the various forms of carrier screening, a synopsis of recent changes in society recommendations and current practice guidelines, and discussion of clinical challenges associated with carrier screening. Evidence Acquisition Published practice guidelines from relevant professional societies were reviewed and synthesized. PubMed search was performed for relevant history and clinical considerations of carrier screening. Results Information and evidence summarized in this review include professional society practice guidelines, review articles, and peer-reviewed research articles. Conclusions and Relevance Current practice guidelines differ between stakeholder professional organizations. Expanded carrier screening offers increased identification of rare disease carriers allowing for more informed reproductive choices. However, there are several barriers to the implementation of expanded carrier screening for all patients. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner should be better able to describe the difference between ethnicity-based, pan-ethnic, and expanded carrier screening; explain current practice guidelines from the American College of Obstetricians and Gynecologists and the American College of Medical Genetics and Genomics; and identify the barriers to implementation of expanded carrier screening.