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September 9th, 2010
12:37 PM ET

Sickle cell screening for college athletes is questioned

Testing all college athletes for sickle cell disease needs to be reconsidered, according to the Johns Hopkins Children's Center .

This is the first season in which all Division I college athletes will get screened for the sickle cell trait, in addition to their regular physicals. A new program adopted by the National Collegiate Athletic Association (NCAA) is testing athletes to find out whether they carry the genetic mutation for sickle cell. The goal is to determine which athletes are more at risk for health complications or sudden death from intense exercise.

ThJohns Hopkins Children's Center is urging the NCAA to reconsider this program, in a commentary published Thursday in the New England Journal of Medicine. The Hopkins physicians say that the program needs to find a way to eliminate false positives, offer post-test counseling for the athletes and figure out a way to prevent future discrimination against athletes based on a positive test.

About 170,000 college athletes will get screened starting this fall and while the majority of them won't be affected, researchers estimate that between 400 and 500 athletes will find out they carry the gene. The risk for exercise related sudden death is 10 to 30 times higher among sickle cell carriers than those who aren't, which is why college athletes are more at risk.

In the United States all newborns get screened for sickle cell disease. However, it is possible for people who inherit one sickle cell gene and one normal gene to not know they carry the sickle cell "trait" because they don't experience any symptoms. Newborn screening only detects disease, not genetic traits. According to the CDC, more than 2 million Americans are believed to carry the sickle cell mutation but don't actually have sickle cell disease.

The NCAA program was implemented after a 19-year-old football player’s death was linked to the sickle cell gene.


soundoff (26 Responses)
  1. pants on fire

    Inaccurate information. Both my children were tested at birth for sc trait, and they both have it. We were shocked as both parents are caucasion and thought this was a african american gene. found out it occurs in meditteranian background also, and also as a straight mutation. I think mine came from the Mellungeons. (We are southern) We know to tell the schools and coaches to ease our children into any sports or conditioning. The problem is whether or not they will abide by our order, as coaches are notorious for "doing it their way" and pushing kids with laps, suicides, up/downs, etc, etc. Hopefully this will enlighten the coaches out there so kids stop dropping on the fields and the court!

    September 9, 2010 at 16:43 | Report abuse | Reply
    • ladylee

      I am stationed (NAVY) in Africa and I have not seen or heard of one case of Sickle Cell. AIDS, HIV and other disease by all means yes. I am very curious, how Sicke Cell even entered US. Why are only African Americans mostly affected by this disease. I have Sickle Cell Trait and so do my daughters. My great-grand father was from the Mid-East, (India). My great-grand mother was native American.

      September 10, 2010 at 03:40 | Report abuse |
  2. Young Sinatra

    They are FULL of SH*&!! JUST having the 'triat' dose NOT do anything!! The ONLY thing I cation MY two sons about is TRYING not to MARRY a women who ALSO has the 'trait' for fear of having a child WITH sickle cell disease.

    September 9, 2010 at 17:26 | Report abuse | Reply
    • concerned bystander

      having sickle cell trait is not a completely benign medical condition – extreme conditions such as profound dehydration, hypothermia, hypoxia and even general anesthesia can precipitate a sickle cell crisis in sickle cell trait patients, although these patients tend to have a larger margin of safety as compared with patients who have sickle cell disease (two genes for sickle cell instead of just one). please do not spread misinformation simply because you are ill informed.

      September 9, 2010 at 17:48 | Report abuse |
    • Megan

      What? Sickle cell trait does in fact affect your blood cells. Also, if having the trait does nothing how are your sons supposed to avoid marrying a woman who might also have some mysterious unobservable gene?

      September 9, 2010 at 19:16 | Report abuse |
  3. fuyuko

    don't want a test? sign a waiver. DONE! but personally, if I had the potential to have this kind of illness- I'd want to know.

    September 9, 2010 at 18:25 | Report abuse | Reply
  4. breed it out

    Sickle cell disease should be bred out of the population just like Ashkenazi Jews have done a good job eliminating infant onset Tay Sachs. They all get screened under a code and are only told certain people are off limits for marriage. Or people can marry whom they please and be disciplined about not having any kids of their own and adopting instead. You can choose your friends and enemies but our genes are thrust upon us by parents who don't care about their kid's suffering. They just want to coo "oh, he has YOUR eyes! and MY mouth! Ooohhhh!"

    September 9, 2010 at 19:38 | Report abuse | Reply
    • Jenn

      Unlike Tay Sachs, Sickle cell does have some evolutionary advantages for fighting malaria.

      September 9, 2010 at 22:13 | Report abuse |
  5. Ituri

    The testing could be used to single out players with nothing wrong with them. Plenty of people carry one gene, and it most often does NOT effect them. Only very rarely does it effect them.

    Medical testing should be done ONLY for private knowledge, not by mandate of some frivolous sporting pursuits desire to limit their legal liability.

    September 9, 2010 at 22:38 | Report abuse | Reply
  6. ZanyJany

    Sickle Cell can affect African and Mediterranean people and you don't know you have the trait until you drop dead while exercising. Therefore ,I think it's good for all to know if they have it so they can know what to do ,if they participate in heavy exercise and sports ,which is so common in America. The US. started testing all babies in 1995-but most trait carries and their parent weren't told about the death-by-exercise factor of Sickle Cell trait status.

    September 10, 2010 at 03:12 | Report abuse | Reply
  7. chaskavitch

    ladylee: The deformation in the red blood cells caused by the sickle cell trait makes it more difficult for the blood cells to be infected by malaria parasites. Since there is such a high prevalance of malaria in parts of Africa, the people with sickle cell traits were the ones that didin't die of malaria and therefore were the ones to have kids and pass on their genes. I imagine that the same thing could have happened in other areas of the world that have a lot of malaria, like in India.

    September 10, 2010 at 12:34 | Report abuse | Reply
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