Genetic screening for iron overload: No evidence of discrimination at 1 year

Wake Forest University Medical School, Department of Public Health Sciences, 2000 West 1st Street, Winston-Salem, NC 27157-1063, USA.
The Journal of family practice (Impact Factor: 0.89). 11/2007; 56(10):829-34.
Source: PubMed


This study measured the extent of insurance and employment problems associated with population screening for hereditary hemochromatosis and iron overload.
101,168 primary care patients from the US and Canada were screened for iron phenotypes and HFE genotypes associated with hemochromatosis. Those identified to be at risk (2253) were offered a clinical examination, which 1677 (74%) accepted, and the 1154 of these who responded to an initial questionnaire about psychosocial issues were surveyed 1 year later about whether they had experienced problems with insurance or employment that they attributed to hereditary hemochromatosis and iron overload.
832 (72.1%) of the 1154 participants surveyed after 1 year responded to the second survey. Three (0.4%) had verified problems with insurance or employment that they believed were related to hereditary hemochromatosis and iron overload. Two had problems with life insurance, and one with long-term care insurance. All 3 had elevated iron levels but not a relevant HFE genotype. One of the life insurance problems was resolved; the second one was not serious. The participant who was denied long-term care insurance had other health conditions unrelated to hereditary hemochromatosis and iron overload that could have contributed to the denial. No problems were verified for health insurance or employment, or from any of the comparison group participants (controls and those with inconclusive screening results).
The risk of insurance or employment problems 1 year after phenotype and genotype screening for hereditary hemochromatosis and iron overload is very low.

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    • "Around half of the studies reviewed (48%) found that, although GD had some empirical basis, its incidence was rare and it was not a significant source of insurance denials [4,14,16,17,19-22,27,31,39,40,42,44]. A second category, comprising a considerable number of studies (42%), concluded that the existence of GD in life insurance was documented by the evidence they provided and that the situation gave grounds for serious concern. "
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