Nationwide Implementation of Newborn Screening for Spinal Muscular Atrophy in Canada
In brief
Canada's newborn screening identifies SMA in about 1 in 12,500 births
Since screening began in 2020, Canada has screened more than 1.5 million infants and identified 120 with SMA, for a national birth prevalence of about 1 in 12,524. Screening is now nationwide, but provinces differ in testing and reporting, and reimbursement remains uneven, particularly for infants with four SMN2 copies; equitable access to early treatment remains unresolved.
- Journal
- Neurology. Genetics (Q1)
- Published
- 15 October 2026
- Study design
- Cross-sectional study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Hugh J McMillan, Homira Osman, Kristin Kernohan, Melanie Lacaria, Stacey Lynn Hume, Andrew Muranyi, et al.
- PMID
- 42899123
- DOI
- 10.1212/NXG.0000000000200451
Why clinicians should know about it
- Picked for Genetics (clinical) (paper of the day, 21 October 2026): National SMA screening and treatment access inform genomic medicine
Abstract
BACKGROUND AND OBJECTIVES: Newborn screening (NBS) for spinal muscular atrophy (SMA) and reimbursement of disease-modifying therapies (DMTs) are managed provincially in Canada, creating inequities in diagnosis and treatment. We describe NBS methodology, reporting practices, and DMT reimbursement across Canada and report the first national birth prevalence of SMA. METHODS: We conducted a cross-sectional survey of laboratory directors from each provincial NBS program, validated against publicly available government sources (censored December 31, 2025). Birth prevalence was calculated using a Poisson 95% CI. The study met research ethics board deferral criteria as a quality assurance study. RESULTS: Since NBS initiation (Ontario, in January 2020; full national coverage, in August 2024), 1,502,890 infants were screened. Of the 120 infants reported to have homozygous absence of exon 7 in SMN1, the estimated national birth prevalence was 1 in 12,524 births (95% CI 1:10,554 to 1:15,245 births). The distribution of SMN2 copy numbers in newborns with SMA identified 2 newborns (1.7%) with one copy of SMN2, 51 (42.5%) with 2 copies of SMN2, 41 (34.2%) with 3 copies of SMN2, 23 (19.2%) with 4 copies of SMN2, and 3 (2.5%) with 5 copies of SMN2. First-tier testing methodology and second-tier confirmation varied by province, as did the timing of SMN2 copy number availability at first family contact. DMT reimbursement for infants with 4 copies of SMN2 is not nationally harmonized. DISCUSSION: Canada achieved universal SMA screening in August 2024; however, interprovincial variability persists in testing methodology, SMN2 copy number reporting, and DMT access. Infants with 4 copies of SMN2 face particularly inequitable treatment access despite growing expert consensus supporting early treatment initiation. Ongoing work is needed to eliminate inequity in regional drug reimbursement criteria for Canadian newborns identified with SMA on NBS.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.