Implementation of the French nationwide cystic fibrosis newborn screening program

J Pediatr. 2008 Aug;153(2):228-33, 233.e1. doi: 10.1016/j.jpeds.2008.02.028. Epub 2008 Apr 18.


Objectives: To describe optimization of a nationwide newborn screening program for cystic fibrosis (CF) that combines an immunoreactive trypsinogen (IRT) assay and DNA mutation analysis in dried blood samples at day 3.

Study design: Data from regional screening laboratories and CF care centers were centralized and periodically analyzed to allow adaptation, thus limiting the number of false-positive cases.

Results: A total of 2717905 infants were screened between 2002 and 2005. Flow chart protocol was modified twice. First, the IRT d3 cutoff value increased from 60 to 65 microg/L, thus decreasing the percentage of samples requiring mutation analysis from 0.82% to 0.64%. Second, for infants with no mutations using the screening panel, a recall for IRT was performed only if IRT d3 was > 100 microg/L; the percentage of recalls decreased from 0.51% to 0.12%, and the percentage of infants requiring a sweat test decreased from 0.14% to 0.01%. No significant change in the CF detection rate was observed after these 2 modifications. A total of 625 CF cases were detected, and 22 false-negative findings (3.4%) were observed, most of them inevitable, with a low initial IRT.

Conclusions: The centralized data analysis led to changes in the screening strategy to optimise the newborn screening program.

MeSH terms

  • Cystic Fibrosis / diagnosis
  • Cystic Fibrosis / epidemiology*
  • Cystic Fibrosis / prevention & control*
  • False Negative Reactions
  • France / epidemiology
  • Genetic Testing / organization & administration
  • Health Plan Implementation*
  • Humans
  • Incidence
  • Infant, Newborn
  • Mandatory Testing / statistics & numerical data
  • National Health Programs*
  • Neonatal Screening / organization & administration*
  • Program Development