4.7 Review

Genomic newborn screening for rare diseases

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NATURE REVIEWS GENETICS
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NATURE PORTFOLIO
DOI: 10.1038/s41576-023-00621-w

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Rare diseases are a significant cause of infant mortality and lifelong disability. Genomic sequencing has revolutionized diagnosis and offers the potential to greatly expand the early detection of treatable rare diseases through newborn screening programs. This review discusses the challenges and opportunities associated with incorporating genomic sequencing into newborn screening, including the need for evidence of benefit and addressing ethical and psychosocial concerns. The authors summarize the current evidence and identify key research priorities.
Rare diseases are a leading cause of infant mortality and lifelong disability. To improve outcomes, timely diagnosis and effective treatments are needed. Genomic sequencing has transformed the traditional diagnostic process, providing rapid, accurate and cost-effective genetic diagnoses to many. Incorporating genomic sequencing into newborn screening programmes at the population scale holds the promise of substantially expanding the early detection of treatable rare diseases, with stored genomic data potentially benefitting health over a lifetime and supporting further research. As several large-scale newborn genomic screening projects launch internationally, we review the challenges and opportunities presented, particularly the need to generate evidence of benefit and to address the ethical, legal and psychosocial issues that genomic newborn screening raises. In this Review, the authors summarize the current evidence for the use of genomic sequencing in newborn screening for rare diseases. As several large-scale studies launch internationally, the authors discuss major challenges and opportunities that lie ahead and identify key research priorities.

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