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July 8, 1974

Sicklemia: To Screen or Not to Screen

JAMA. 1974;229(2):192. doi:10.1001/jama.1974.03230400054037

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Erythrocyte sickling is a common genetic disorder among the black population of the United States. Sickle cell anemia results when the hemoglobin is all of the sickle type (SS). Also, when S hemoglobin is linked with another abnormal hemoglobin (as in S-thalassemia or SC) disease, though less dreadful, results. By far most frequent is the condition in which S hemoglobin is linked with normal hemoglobin— AS, the sickle cell trait.

Understandably, these hereditable disorders have increasingly troubled the national conscience during the past few years. Mass screening programs are in progress to discover SS disease in neonates so that they can be "protected" insofar as possible and to discover the AS disorder in young adults so that they can be "counseled."

Efforts to discover the sickle cell trait have elicited mixed emotions among the population at risk. Some have issued denunciations on the grounds that the whole thing is a