The UK National Screening Committee (UK NSC) has opened a consultation on evidence relating to screening for biliary atresia in newborns.
Biliary atresia is one of the health conditions the committee reviews regularly for evidence relating to newborn screening.
Evidence summaries are typically the second step in the UK NSC process of reviewing evidence. We are asking individuals and organisations to provide feedback on the findings and conclusions of a 2025 evidence summary on screening for biliary atresia in newborns.
The 2025 evidence summary concludes that there is currently not enough evidence to recommend screening for biliary atresia in newborns.
How to respondTo take part in the consultation, download the consultation documents by clicking on the grey ‘View documents’ button on the UK NSC’s biliary atresia condition recommendation page. Then submit your response by clicking on the green ‘Submit comments’ button.
The deadline for responses is 11.59pm on 20 May.
About biliary atresiaBiliary atresia is a rare disease where the bile ducts become inflamed and blocked. Bile ducts are thin tubes that carry bile from the liver and gallbladder to the small intestine, where bile helps digest fats in food.
Symptoms develop within a few weeks of birth. Without treatment, biliary atresia can cause death by the age of 2 years old. There are approximately 37 cases of biliary atresia in the UK each year. The only treatment for biliary atresia is a type of surgery called the Kasai procedure. This surgery is more likely to be successful if done before 60 days of age.
The use of newborn dried blood spots and stool colour cards are 2 possible ways to screen for biliary atresia. There are national screening programmes using stool colour cards in Japan and Taiwan, where the condition is more common than in Western nations.
The UK NSC does not currently recommend screening newborns for biliary atresia because:
the accuracy of the 2 tests that might be used remains uncertain, based on current evidence countries that do screen for biliary atresia perform surgery at the same age as the UK, so the value of screening in bringing forward care is uncertain The 2025 evidence summaryThe 2025 evidence summary considered new evidence published since 2012. It found:
not enough evidence to recommend the use of dried blood spots to screen for biliary atresia – one systematic review and 3 individual studies were identified, but the test performance results reported in these studies were limited and there was significant uncertainty in the results the accuracy of stool colour cards to identify biliary atresia was unclear – 2 systematic reviews and 5 individual studies were identified, but test accuracy varied greatly across studies screening using stool colour cards has improved outcomes for infants with biliary atresia in some countries. However, age at surgery in the UK is similar to the age in countries that use stool colour card screeningDuring the public consultation we are asking individuals and organisations to provide feedback on this evidence and to flag any issues they think should be considered.
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seen at 16:35, 25 February in UK National Screening Committee.