One of my patients is entering college this fall, and he wants to play football.  He called our office this week to tell us that his college now requires all athletes (regardless of ethnic background) to have a routine blood test to screen for Sickle Cell Trait.  He asked us for a lab order.

Frankly, I had never heard of such a thing.  But it turns out that in 2008 the NCAA did formally recommend universal screening for Sickle Cell Trait (click here), because of several unexpected deaths during strenuous practice over several decades.  There have been 8 cases reported in the past 10 years.  All the deaths related to Sickle Trait occurred during conditioning exercises, not during games or scrimmages.  (Click here to read a report in the New York Times.)

Many colleges now require all their student athletes (not just African-American football players) to have a blood test for sickle trait before joining the team.  The test requires a doctor’s order at a medical lab, just like any blood test.

The cost may not be covered by insurance.  We called a couple of labs and asked what they charge:
LabCorp:  $82.00 test + $16.00 lab draw = $98.00 total
Quest:  $35.90 test + $15.90 lab draw = $51.80 total

The recommendation for universal Sickle testing has some detractors.  There is no evidence that discovering a student with a positive test has actually saved a life, or altered any training regimens; in fact, 4 of the 8 sickle-positive athletes who died in the past 10 years were already aware of their status before their death.  And mandated testing might lead to discrimination against athletes with Sickle Trait, even though Sickle Trait does not appear to affect game-time performance or safety.

But, in any case, we will be happy to help you comply with this recommendation.  Let us know if you need a blood test order.  If the test is positive, we’ll discuss it with you; and in any event, everybody (regardless of blood test status) should stay hydrated during strenuous exercise!

–  David Epstein, MD