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To screen or not to screen for sickle cell trait in American football?
  1. Kimberly G Harmon1,
  2. Jonathan A Drezner2,
  3. Douglas J Casa3
  1. 1Department of Family Medicine and Sports Medicine and Orthopaedics, Hall Health Sports Medicine Clinic, University of Washington, Seattle, Washington, USA
  2. 2Department of Family Medicine, Hall Health Sports Medicine Clinic, University of Washington, Seattle, Washington, USA
  3. 3Department of Kinesiology, Neag School of Education, University of Connecticut, Connecticut, USA
  1. Correspondence to Kimberly G Harmon, Departments of Family Medicine and Sports Medicine and Orthopaedics, 4060 East Stevens Circle, Hall Health Sports Medicine Clinic, University of Washington, Seattle, WA 98195, USA; kharmon{at}u.washington.edu

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Sickle cell trait (SCT) in America football athletes has been a topic of recent media attention. The deaths of college football athletes Ereck Plancher, Aaron O’Neil, Dale Lloyd and others as well as the recent decision of Pittsburgh Steelers safety Ryan Clark to forego a play-off game at altitude in Denver have contributed to the characterisation in the lay press of SCT as a dangerous condition. In fact, deaths in National Collegiate Athletic Association (NCAA) football players and concern from NCAA member institutions for the health and safety of student athletes led to legislation mandating all Division I athletes be screened or know their SCT status since August of 2010. On 26th January 2012, the American Society for Haematology (ASH) denounced the NCAA position. The disparity between these two positions is striking and deserves comment.

The relevant facts

SCT is common, with 1 in 14 (7%) of blacks having SCT and up to 1 in 625 Caucasians carrying the gene. SCT is …

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