Incorrect recall of residual risk three years after carrier screening for cystic fibrosis: A comparison of two-step and couple screening

OBJECTIVE: This study was undertaken to compare long-term recall of the meaning of lest results after a negative result of 2-step or couple antenatal screening.
STUDY DESIGN: In a randomized controlled trial a subject-completed questionnaire was sent to 275 women who had undergone couple testing 3 years earlier and 83 women who had undergone 2-step testing 3 years earlier (n = 263/358 for a response rate of 73%). The main outcome measure was understanding of test results.
RESULTS: Three years after testing women who had undergone couple testing were 4.5 times (95% confidence interval 2.4-8.4 times) more likely than those who had undergone 2-step testing to accurately recall that the test result meant that they were unlikely to be carriers for cystic fibrosis (80%, 95% confidence interval 74%-86%, versus 49%, 95% confidence interval 36%-61%). Anxiety level, plans to have more children, and age were unrelated to recall.
CONCLUSION: The results of this study, together with those from other evaluations. suggest that not only does couple testing avoid the high levels of anxiety associated with 2-step testing but it also results in greater awareness of the residual risk inherent in a negative screening test result.