Before pregnancy, genetic carrier screening can identify couples who both carry changes linked to the same inherited disorder, allowing them to estimate the chance of having an affected child. Traditionally, testing was chosen based on a person’s reported ethnic background, on the belief that certain variants occur primarily in specific populations. In this study, we analyzed data from more than 100,000 participants in a national carrier screening program and showed that offering the same screening panel to everyone identified more carriers and more couples at risk of having an affected child than ethnicity-based screening. The findings support broader pan-ethnic screening and regular updating of panels. (https://jmg.bmj.com/content/early/2026/08/12/jmg-2026-111670)