Sickle cell anemia (homozygous hemoglobin S disease) occurs in approximately one out of every 600 black American newborns. This high prevalence, combined with well-recognized morbidity and mortality, make it an important health problem in this country—a far greater problem than other genetic diseases for which early detection programs have been legally mandated for more than a decade. Until recently, there have been few programs for the early detection of sickle cell anemia. There are two justifications usually cited for this lack of action: first, the diagnosis may be technically difficult to establish in the first few months of life because of the large amounts of hemoglobin F characteristic of this period, and second, since there is no cure or even effective therapy for sickle cell anemia, it is widely believed that there is no particular advantage to early diagnosis.
The article by Sexauer and associates (p 805) is primarily addressed