Issues associated with possible implementation of Non‐Invasive Prenatal Testing (NIPT) in first‐tier screening: A rapid scoping review.

In recent years, as the implementation and use of Non‐Invasive Prenatal Testing (NIPT) have increased, the cost of the test has been decreasing. The cost of NIPT is expected to fall further in the upcoming years. As a result of the decreasing cost of NIPT, many jurisdictions may change their prenatal screening policies toward abandoning serum‐based screening and instead, implement and support NIPT as the first‐tier screening for all women. There are several concerns in replacing first‐trimester screening with NIPT. In this scoping review, we aimed to map the existing knowledge about possible issues in the systematic implementation of NIPT as the primary method of first‐tier screening and to assess if any jurisdiction has altered its policy and discontinued serum‐based prenatal screening in exchange for NIPT. The Medline database (Ovid) and Google Scholar was searched and all the studies discussing, investigating, or reporting on the systematic implementation of NIPT as the primary method of first‐tier screening were included. All the studies went through a two‐stage screening process and included full‐text articles were reviewed. We did not find any articles indicating a country or region that replaced traditional prenatal screening by NIPT. The included articles were charted, and the data about the possible issues in the systematic implementation of NIPT as the primary method of first‐tier screening are summarized narratively and presented in tables in four categories. The findings of this scoping review may be informative for stakeholders and policymakers regarding recent changes in NIPT implementation policies around the world and may aid with developing policy for NIPT implementation with a broader perspective. Key points: What's already known about this topic? Non‐Invasive Prenatal Testing (NIPT) is implemented mainly as a contingent test after a high‐risk assessment, and in a few instances, as a first‐tier test.More recently, as the use of NIPT has increased, the cost of the test has been decreasing, and two countries (Belgium and Netherland) now offer NIPT as the primary screening test to all pregnant women. What does this study add? It maps existing knowledge about various possible issues in implementing NIPT as a first‐tier screening test.It documents what jurisdictions have changed their policy toward implementing NIPT instead of traditional prenatal screening in the first trimester. [ABSTRACT FROM AUTHOR]