Genetic screening is public health program that gives individuals to have the opportunity to be identified with a genetic diseases for "prevention, early treatment or reproductive options" (Stickler, 2010). There are three types of genetic screenings which are mass, opportunistic and cascade screening. Mass screening is a test that involves recruits individuals with a targeted population and recruits more from an organized way. Opportunistic screening is more voluntary when the individual contact the health system and cascade screening involves more individuals who do not show symptoms but are tested because of their relative with a pre-existing disease or is a carrier. Figure 1 explains the population based genetic screening against clinical setting genetic testing (Stickler, 2010). .
Cascade screening seems to be more controversial than the other types of screening. This screening seeks out relatives with a certain genetic disorder to help treat properly for family members affected. For example, cascade screening is being used for the disorder called familial hypercholesterolemia (FH). FH is one of the first genetic disorder that is screened by cascade screening as well as hereditary breast and ovarian cancer and Lynch syndrome. After a member of the family is testing they are known as an "index case", then immediate family is tested for the gene afterwards second and third generation are testing as well (FH Foundation). The reason for the controversy of this screening is the contact and protecting the individuals tested. This type of screening would not be successful unless all participants of the family is willing to provide information for the clinic to contact. Moreover, there are genetic tests for hereditary breast and ovarian cancer to check for BRCA1 and BRCA 2 mutations which can involve cascade screening but mostly involve genetic counseling which was recommended by the U.