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Sickle cell screening: who should be tested | CION Cancer Clinics
Test if your family comes from a community where sickle cell is common, if a relative has the disease or trait, or before marriage or pregnancy in such a family. Screening is free under the national mission in affected areas. A quick solubility or rapid test shows whether sickle haemoglobin is present. A positive screen is then confirmed with HPLC or electrophoresis, which tells trait from disease. At CION Cancer Clinics, our haematologist cares for anaemia, bleeding, clotting and inherited blood disorders, with ArogyaSri, CGHS and cashless insurance accepted.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Who should get a sickle cell screening test?
- Which people are usually offered sickle cell screening?
- What happens from the first screen to a confirmed result?
- What does each screening result mean for you?
- What do families often get wrong about screening?
- What can a screening test not tell you?
- Common questions about sickle cell screening
The short answer
Who should get a sickle cell screening test?
Get tested if your family comes from a community where sickle cell is common, if a relative has sickle cell disease or trait, or if you are planning a marriage or a pregnancy in such a family. A newborn or young child with unexplained pain, swelling or a low haemoglobin should be tested too.
Why a healthy adult is tested at all
Most people who carry one sickle gene feel completely well. This is called sickle cell trait. You cannot tell from how you feel, or from a normal-looking blood count, whether you carry it. The trait matters when two carriers have children together, because each child can then inherit two sickle genes and have the disease.
Why it matters in Telangana and Andhra Pradesh
Sickle cell is found most often among tribal communities in central, western and southern India, including families from tribal districts of Telangana and Andhra Pradesh. It also appears in non-tribal families, so a community name is a reason to test, not a reason to skip the test. Under the national sickle cell elimination mission, people in affected areas are offered free screening through government health centres.
What screening does not do
A screening test answers one question: is sickle haemoglobin present or not? It does not tell you how unwell someone will be, and a positive screen is not yet a diagnosis.
A screening result is read alongside a confirmatory test, the full blood count and the family history. Never on its own.Who is asked to test
Which people are usually offered sickle cell screening?
If you fit any one of these, ask for the test. You do not need symptoms first.
Couples before marriage or pregnancy
Testing both partners early gives you time to understand the chance of a child being affected, and to talk to a haematologist or genetic counsellor before decisions are made.
Pregnant women in affected families
If the mother carries the trait, the father is offered a test. If both carry it, testing of the baby before birth can be discussed early in the pregnancy.
Newborns and young children
Babies born to a parent with the trait or disease are tested so that preventive care can begin early.
Some screening tests are unreliable in the first months of life. Babies need a confirmatory method.Brothers, sisters and cousins
When one child is diagnosed, the rest of the family is often tested. Relatives may carry the trait without knowing it.
Anyone with suggestive symptoms
Signs that should prompt a test
- Painful swelling of a young child's hands or feet
- Repeated episodes of severe bone or joint pain
- Yellow eyes with low haemoglobin that iron does not fix
Not sure whether this applies to you?
Ask an oncologistThe pathway
What happens from the first screen to a confirmed result?
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A quick screening test
A small blood sample is tested with a solubility test or a rapid point-of-care kit. In mission camps and government centres, this is usually done on the spot or within a day.
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A screen-positive result
If sickle haemoglobin is found, the result reads positive. At this stage nobody can yet say whether it is trait or disease.
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A confirmatory test
The sample, or a fresh one, is sent for HPLC or haemoglobin electrophoresis. These tests measure each type of haemoglobin separately and show the pattern.
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The result is explained
A doctor tells you whether the pattern shows trait, sickle cell disease or a mixed form with thalassaemia. Bring your family history to this visit.
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A status card and a plan
People screened under the mission are given a card showing their status. If the result shows disease, you are referred for regular care with a haematologist.
Reading the result
What does each screening result mean for you?
What the report says
What it usually means next
Screen negative
No sickle haemoglobin was found. In babies or after a recent transfusion, ask whether a repeat is needed
Screen positive
Sickle haemoglobin is present. A confirmatory test is needed to tell trait from disease
Confirmed trait (AS)
You carry one gene. Usually no treatment is needed, but your partner should be tested
Confirmed disease (SS or a mixed form)
Lifelong care with a haematologist, starting as early as possible
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Commonly believed
What do families often get wrong about screening?
"We are healthy, so we cannot be carrying anything."
People with sickle cell trait almost always feel well. Many parents only find out they are carriers after their child is diagnosed. A blood test is the only way to know.
"A positive screen means my child has the disease."
A positive screen only means sickle haemoglobin was found. Many people who screen positive turn out to have the trait, which usually needs no treatment. Wait for the confirmatory report before deciding what it means.
"Our marriage will be spoiled if we test."
Knowing your status does not stop a marriage. It lets a couple understand the chances for their children and plan with a doctor. Many carrier couples have children who are unaffected or who carry only the trait.
"The normal blood count last year already ruled it out."
A routine blood count does not look for sickle haemoglobin. Trait usually gives a normal count. Only a sickling, solubility, HPLC or electrophoresis test answers the question.
Did you know
Under the national sickle cell elimination mission, children and younger adults in affected areas are offered free screening and a card showing their status. Keep that card safe and show it before marriage counselling or at the first pregnancy visit.
Being straight with you
What can a screening test not tell you?
A screening test cannot tell you how severe sickle cell disease will be. Two children with the same result can have very different lives. How often pain comes, which organs are affected and how the outlook looks depend on many things a single test does not measure.
It can miss some results
Rapid screening tests can give a false negative, meaning the test misses sickle haemoglobin that is really there. This happens more often in young babies, in people with a very low haemoglobin and after a recent blood transfusion. If there is a strong family history and the screen is negative, ask whether a confirmatory test is still worth doing.
It does not replace a doctor's reading
Reference ranges and report formats differ between laboratories. A single result is always read alongside symptoms, the full blood count and, where needed, a repeat test. Do not start or stop any medicine because of a screening report alone.
What to do next
Take the report and your family history to a haematologist. At CION, the haematology team reviews the report, arranges the right confirmatory test through an accredited laboratory, and explains what the result means for you and for your children.
Questions we are asked
Common questions about sickle cell screening
Which test is used for sickle cell screening in India?
The most common first test is the solubility test, sometimes called the sickling test, or a rapid point-of-care kit. Both show whether sickle haemoglobin is present. A positive result is then confirmed with HPLC or haemoglobin electrophoresis, which tell trait apart from disease. Your doctor chooses the test based on age and history.
Is sickle cell screening free under the government mission?
In areas covered by the national sickle cell elimination mission, screening is offered free at government health centres and screening camps. Coverage and eligibility can change, so check the current rules with your nearest primary health centre or district hospital. Private laboratories charge separately for confirmatory tests.
Do I need to fast before the test?
No. Sickle cell screening does not need fasting. It is a simple blood sample, often from a finger prick for rapid kits or from a vein for laboratory tests. Tell the person taking the sample if you have had a blood transfusion recently, because that can change the result.
Can a newborn baby be screened?
Yes, but the method matters. In the first months of life a baby's blood still holds mostly the haemoglobin made before birth, so a simple solubility test can miss sickle cell. Newborns are tested with HPLC or a similar method that measures each type of haemoglobin. Ask the paediatrician which test was used.
My husband and I both have the trait. What now?
Meet a haematologist or genetic counsellor before or early in pregnancy. With two carrier parents, each pregnancy has a chance of a child with the disease, a chance of a child with the trait, and a chance of an unaffected child. Testing of the baby before birth is possible and can be discussed early.
Does sickle cell trait need treatment?
Usually not. Most people with trait live normal lives and need no regular medicine. It is sensible to drink enough water in hot weather and during hard physical work. Tell your doctors about the trait, and make sure your partner is tested before planning children.
Can the screening result be wrong?
Yes, occasionally. A screen can miss sickle haemoglobin in young babies, after a transfusion or when haemoglobin is very low. That is why every positive screen is confirmed, and a negative screen is sometimes repeated when the family history is strong. Ask your doctor whether your result needs confirming.
Where can I get a confirmatory test in Hyderabad?
Government hospitals and many accredited private laboratories offer HPLC or electrophoresis. If you already have a screening report, CION's haematology team can read it with you, advise which confirmatory test fits, and coordinate it. Bring any earlier reports and the status card if you have one.
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Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- NHS — Sickle cell disease
- National Heart, Lung, and Blood Institute — Sickle cell disease
- American Society of Hematology — Blood disorders: patient education
- National Health Mission — National Health Mission
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Solubility Test and Confirmatory TestingWhat happens after a positive screenSickle Cell Trait vs DiseaseIf your result says trait or ASThe National Sickle Cell Elimination MissionFree screening and the status cardSickle Cell in PregnancyIf you are planning a familySickle Cell DiseaseThe full guide to the condition
Talk to us
Have a sickle cell screening report?
Share it with us. CION's haematology team will read it with you and explain which confirmatory test, if any, you need next. One helpline serves every CION centre.