Even though genetic mutations seen in haemochromatosis are not uncommon in the general population, only a small subset of people with the mutation will develop symptoms and an even smaller subset will develop advanced disease.[23]Allen KJ, Gurrin LC, Constantine CC, et al. Iron-overload-related disease in HFE hereditary hemochromatosis. N Engl J Med. 2008 Jan 17;358(3):221-30.
http://www.nejm.org/doi/full/10.1056/NEJMoa073286#t=article
http://www.ncbi.nlm.nih.gov/pubmed/18199861?tool=bestpractice.com
[52]Olynyk JK, Hagan SE, Cullen DJ, et al. Evolution of untreated hereditary hemochromatosis in the Busselton population: a 17-year study. Mayo Clin Proc. 2004 Mar;79(3):309-13.
http://www.ncbi.nlm.nih.gov/pubmed/15008603?tool=bestpractice.com
[53]Andersen RV, Tybjaerg-Hansen A, Appleyard M, et al. Hemochromatosis mutations in the general population: iron overload progression rate. Blood. 2004 Apr 15;103(8):2914-9.
http://www.bloodjournal.org/content/103/8/2914.full
http://www.ncbi.nlm.nih.gov/pubmed/15070663?tool=bestpractice.com
As such, major guidelines do not recommend screening of the asymptomatic general population; however, screening of family members of patients with haemochromatosis is supported by the American Association for the Study of Liver Diseases, the American College of Gastroenterology, the British Society for Haematology, and the European Association for the Study of the Liver.[4]Kowdley KV, Brown KE, Ahn J, et al. Correction: ACG clinical guideline: hereditary hemochromatosis. Am J Gastroenterol. 2019 Dec;114(12):1927.
http://www.ncbi.nlm.nih.gov/pubmed/31724994?tool=bestpractice.com
[7]Kowdley KV, Brown KE, Ahn J, et al. ACG clinical guideline: hereditary hemochromatosis. Am J Gastroenterol. 2019 Aug;114(8):1202-18.
https://journals.lww.com/ajg/fulltext/2019/08000/acg_clinical_guideline__hereditary_hemochromatosis.11.aspx
http://www.ncbi.nlm.nih.gov/pubmed/31335359?tool=bestpractice.com
[8]European Association for the Study of the Liver. EASL clinical practice guidelines on haemochromatosis. J Hepatol. 2022 Aug;77(2):479-502.
https://www.journal-of-hepatology.eu/article/S0168-8278(22)00211-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/35662478?tool=bestpractice.com
[54]Bacon BR, Adams PC, Kowdley KV, et al. Diagnosis and management of hemochromatosis: 2011 practice guideline by the American Association for the Study of Liver Diseases. Hepatology. 2011 Jul;54(1):328-43.
http://onlinelibrary.wiley.com/doi/10.1002/hep.24330/full
http://www.ncbi.nlm.nih.gov/pubmed/21452290?tool=bestpractice.com
[55]Fitzsimons EJ, Cullis JO, Thomas DW, et al. Diagnosis and therapy of genetic haemochromatosis (review and 2017 update). Br J Haematol. 2018 May;181(3):293-303.
https://www.doi.org/10.1111/bjh.15164
http://www.ncbi.nlm.nih.gov/pubmed/29663319?tool=bestpractice.com
Siblings are expected to have a 25% chance of having haemochromatosis.[8]European Association for the Study of the Liver. EASL clinical practice guidelines on haemochromatosis. J Hepatol. 2022 Aug;77(2):479-502.
https://www.journal-of-hepatology.eu/article/S0168-8278(22)00211-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/35662478?tool=bestpractice.com