National Screening Unit

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The National Screening Unit is a unit within the Health and Disability National Services Directorate of the Ministry of Health of New Zealand. They coordinate various medical screening programs in New Zealand, with a focus on woman and infants, including the unborn.

Screening Programmes

The currently offered screening programmes are listed below: [1]

  • BreastScreen Aotearoa - screens women for breast cancer
  • National Cervical Screening Programme - screens women for abnormal changes to cells on the cervix
  • Newborn Metabolic Screening Programme - screens newborn babies for certain metabolic disorders
  • Antenatal HIV Screening Programme - screens pregnant women for HIV to reduce the chances of HIV being passed to the baby
  • Universal Newborn Hearing Screening Programme - screens newborn babies for hearing loss

Personnel

Technical Working Group

As at Sept. 30, 2010, the following were members of the Technical Working Group:[2]

  • Peter Stone, representative, Royal Australian and New Zealand College of Obstetricians and Gynaecologists
  • Dr. Malcolm Battin, Clinical Director, Newborn Services
  • Diane Doehring, nominee for Office of Disability Issues
  • Dr. Richard MacKay, pathologist, Canterbury Health Laboratories
  • Dr. Rachael McEwing, Royal Australian and New Zealand College of Radiologists and representative, Australasian Society of Ultrasound in Medicine
  • Dr. Kate Neas, Genetic Services representative
  • Zandra Vaccarino, representative, New Zealand Down Syndrome Association
  • Stephanie Vague, representative, New Zealand College of Midwives
  • Dr. Dianne Webster, Director, LabPLUS
  • Dr. Jon Wilcox, representative, Royal New Zealand College of General Practice
  • Lynda Williams, representative, Maternity Services Consumer Council

Jane McEntee, Manager, Antenatal and Newborn Screening was responsible for appointing the members of the group.

Consumer Reference Group

As at 15 June 2011, the following served on the Consumer Reference Group for the NSU:[3][4]

Down's Syndrome Screening

The National Screening Unit is pushing for a 'nationally organised screening programme' that screens for Down's Syndrome in unborn infants. Their support for such a programme is conditional on it meeting the following criteria: [5]

  1. universally offered to all pregnant women
  2. accompanied by high-quality, balanced, easily understood information in an accessible range of formats for practitioners and consumers
  3. conditional on informed consent
  4. based on voluntary participation at each stage of the screening and diagnostic pathway
  5. based on unconditional acceptance of, and support for, the choices made by women as a result of screening and diagnostic tests
  6. delivered within a framework that is responsive to Màori and improves opportunities for Màori to make informed decisions
  7. integrated with other tests offered in pregnancy
  8. the safest and most effective tests, based on evolving international evidence
  9. focused on reducing inequalities in access to antenatal screening for Down syndrome
  10. fully funded so that any woman who chooses to have screening is able to access it
  11. monitored and evaluated at a national level.

Potential Impacts

The proposed national screening programme could have far reaching effects. The Dr. Paul Harper, the chair of the Antenatal Down Syndrome Screening Advisory Group, wrote:

"It is important to note that a screening programme will subtly alter the make-up of society, something we must only embark upon after very careful consideration".[6]

In the United Kingdom and Europe 91-94% of unborn infants prenatally diagnosed with down's syndrome are aborted.[7][8] This percentage has been approximately constant since at least 1989. [9] The number of prenatal diagnoses of down's syndrome, as a percentage of total diagnoses, rose from 30%-60% between 1989 and 2000, remaining constant at 60 ± 1% since then. The increase in access to screening has caused a significant increase in the total number of Down's syndrome infants being aborted. As the quote from Dr. Harper above indicates, this is expected to occur in New Zealand also.

External Links

References

  1. National Screening Unit (accessed 3 May 2010)
  2. 30 Sept, 2010 Letter sent to Mr Mike Sullivan from Kelvin Moffatt, Acting Director, National Services Purchasing, National Health Board, regarding a request made under the Official Information Act
  3. NSU: Consumer Reference Group (Google Cache version as at 15 June, 2011 accessed on 29 June, 2011)
  4. West Coast DHB Community & Public Health Advisory Committee: Meeting on 13 Oct 2004 (accessed on 29 June, 2011)
  5. Antenatal Down Syndrome Screening in NZ 2007, pg 54-55 (accessed 3 May 2010)
  6. ibid., pg vi (accessed 3 May 2010)
  7. Caroline Mansfield, Suellen Hopfer, Theresa M. Marteau: Termination rates after prenatal diagnosis of Down syndrome, spina bifida, anencephaly, and Turner and Klinefelter syndromes: a systematic literature review, 1999. Prenatal Diagnosis Journal, Vol. 19, No. 9, pages 808–812
  8. David W. Britt, Samantha T. Risinger, Virginia Miller, Mary K. Mans, Eric L. Krivchenia, Mark I. Evans: Determinants of parental decisions after the prenatal diagnosis of Down syndrome: Bringing in context, 1999. American Journal of Medical Genetics, Vol. 93, No. 5, pages 410–416
  9. The National Down Syndrome Cytogenetic Register 2006 Annual Report, Table 7 (accessed on 3 May 2010)