CASCADE (Cascade Kids newborn screening)
Pacific Northwest Research Institute (Hagopian lab) with the Washington State Newborn Screening Program
What it is
A Washington-state program that screens for Type 1 diabetes and celiac risk using leftover newborn-screening blood spots, with no extra blood draw and no appointment for the first step. Higher-risk children are invited into monitoring.
Editorial review: .
Most recent recorded citation date: 2022-03-21. Only explicit date metadata is included; an undated citation may be newer. This does not mean every claim was reviewed on that date.
Trial status, labels and access can change between reviews. How we review the evidence · How to read the evidence
Evidence behind this assessment
Key evidence notes. Study results, product eligibility and access answer different questions.
- Who was studied?
- Study populations and analysis groups vary. Product age limits alone do not describe who was studied.
- Benefit or performance
- Predictive value: Screens residual newborn blood spots, then confirms with islet-autoantibody testing; follow-up is periodic monitoring with disease-specific autoantibody tests.[3]
- Important harms and treatment burden
- Read the safety discussion and original sources. A missing summary does not establish safety.
- Approval and country access
- Country-specific approval and access are not summarized in this record.Approval, trial recruitment, local supply and funding are separate. Check the cited label or access source.
- Follow-up and remaining uncertainty
- Read the full discussion and original sources for follow-up duration and study limitations.
Editorial score: calculation and evidence
A weighted editorial judgment on a 0–100 scale, not a probability of success or a measured treatment effect. Higher criterion scores mean more favorable assessments.
Default calculation: 78 × 25 + 72 × 25 + 72 × 20 + 92 × 15 + 58 × 15 = 7440; divide by total weight 100. Unrounded weighted result: 74.4.
Screens residual newborn blood spots, then confirms with islet-autoantibody testing; follow-up is periodic monitoring with disease-specific autoantibody tests.[3]
Higher-risk children enter a follow-up monitoring study with periodic autoantibody testing, the pathway that lets families catch progression before symptoms appear.[1]
Designed as true population screening from residual newborn cards (target 75,000 samples over five years) across Washington state, reaching infants regardless of family history; geographically confined to one US state.[1]
The initial screen reuses the leftover state newborn-screening blood spot, so there is no new blood draw and no appointment; only higher-risk children give fresh samples for monitoring.[1]
Open to consenting Washington families during the study, but it is a time-limited feasibility project tied to one state's newborn-screening system, not a permanent service.[2]
The full picture
CASCADE (Combined Antibody Screening for Celiac and Diabetes Evaluation) is a Washington-state program, led by the Pacific Northwest Research Institute in partnership with the state Newborn Screening Program, that tests for Type 1 diabetes (T1D) and celiac risk using blood that has already been collected. After a family consents, the program reuses the leftover dried blood spot from routine state newborn screening, so the first step needs no new blood draw and no appointment.
Screening includes follow-up with islet-autoantibody testing and ongoing monitoring: children flagged as higher-risk are invited into a follow-up study, and PNRI performs surveillance by monitoring infants periodically using disease-specific autoantibody tests.
The goal is reach: by riding existing newborn-screening infrastructure, CASCADE aims to screen on the order of 75,000 samples over five years across the general population, not just families with a history. Children found to be at risk receive monitoring, the route to catching progression before symptoms appear. It is a feasibility effort confined to one state rather than a standing national service.
What's next for this
- →Feasibility readout from up to 75,000 residual newborn blood-spot screens, informing whether genetic-plus-autoantibody screening can ride existing newborn-screening infrastructure at scale
Sources
- [1]TEDDY and CASCADE: Type 1 Diabetes Research Studies · Public health programme
- [2]Newborn Screening Research — CASCADE study · Regulatory decision
- [3]Screening for Type 1 Diabetes in the General Population: A Status Report and Perspective · Peer-reviewed study · 2022-03-21