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Survey of Sickle Cell Trait Screening in NCAA and NAIA Institutions

Abstract Background: Screening for sickle cell trait (SCT) in athletes has been recommended by several professional organizations; however, it is not known how many colleges and universities have implemented such screening in athletes. Aims: This study examines factors related to policies and procedures of SCT screening at colleges and universities, including all divisions of the National Collegiate Athletic Association (NCAA) and the National Association of Intercollegiate Athletics (NAIA) programs. Methods: A total of 375 head athletic trainers or directors of sports medicine from NCAA and NAIA schools responded to an online survey. Results: 21.8% of the respondent institutions screened all of their athletes for SCT, with Division I institutions having the highest rate of screening at 44.6%. A total of 30.1% of the respondent institutions indicated that they screened some of their athletes, with 66.9% of Division I institutions having the highest incidence. Over 26% of respondent institutions did not know if any of their athletes had SCT. Overall, 57% of the institutions counsel athletes about complications of SCT, and 40% of the institutions modify workouts for the athletes. Division I institutions had the highest incidences, with 87.7% providing counseling and 66.1% modifying workouts. The most common criteria for screening are race/ethnicity and family history of SCT. When asked to provide reasons for not screening all athletes, 71.6% of all respondent institutions indicated cost was the primary reason. Conclusion: Screening for SCT remains a relatively uncommon practice in colleges and universities, particularly in NCAA Divisions II and III, and NAIA institutions. From the institutions' perspective, the cost of testing is overwhelmingly the primary reason for not screening all athletes for SCT.