Sourav Roy Chowdhury

The Tata group of companies, which completes 150 years in 2018, traces its beginnings to 1868 when Jamsetji Nusserwanji Tata, the founder, setup India’s first large scale textile mill. It has since emerged to be a global conglomerate with aggregate revenues of more than $100 billion and over 660,000 employees today. The longevity of the group provides an effective counter perspective to the declining lifespan of businesses worldwide—for context, nearly 9 of every 10 Fortune 500 companies from 1955 were either gone, merged, or contracted in 2016 while Tata Steel, Tata Power and the iconic Taj hotel in Mumbai have been around for over a 100 years. This journey has also seen the group navigate multiple evolutions in the operating context for its businesses: setting up industries which contributed to a push for economic self-reliance in independent India, adapting to the post liberalization Indian economy in the nineties, successfully riding out the information technology maelstrom at the turn of this century, aligning to new market paradigms after financial crises of 1997 and 2008 and so on.

Increased knowledge of the gene–disease associations contributing to common cancer development raises the prospect of population stratification by genotype and other risk factors. Individual risk assessments could be used to target interventions such as screening, treatment and health education. Genotyping neonates, infants or young children as part of a systematic programme would improve coverage and uptake, and facilitate a screening package that maximises potential benefits and minimises harms including overdiagnosis. This paper explores the potential justifications and risks of genotyping children for genetic variants associated with common cancer development within a personalised screening programme. It identifies the ethical and legal principles that might guide population genotyping where the predictive value of the testing is modest and associated risks might arise in the future, and considers the standards required by population screening programme validity measures . These are distinguished from the normative principles underpinning predictive genetic testing of children for adult-onset diseases—namely, to make best-interests judgements and to preserve autonomy. While the case for population-based genotyping of neonates or young children has not yet been made, the justifications for this approach are likely to become increasingly compelling. A modified evaluative and normative framework should be developed, capturing elements from individualistic and population-based approaches. This should emphasise proper communication and genuine parental consent or informed choice, while recognising the challenges associated with making unsolicited approaches to an asymptomatic group. Such a framework would be strengthened by complementary empirical research.