Some Thoughts on Consumer Genetic Testing
Posted on Wednesday, April 19th, 2017
“My hope is that 23andMe, by being less and less regulated, will enable more people to open their eyes to science,” said Wojcicki on Wednesday at Fortune’s Most Powerful Women Next Gen conference in Laguna, Nigel. She added that providing her customers with information about their genes can empower them to take a more active role in making decisions about their health.
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“People really thrive when they actually are empowered,” she said, adding that roughly 40% or 50% of 23andMe’s customers have been prompted to make changes to their lifestyle or health habits due to what they’ve learned about their genes.
Unfortunately for her, objective analysis suggests otherwise. As a literature review in the BMJ put it,
Expectations that communicating DNA based risk estimates changes behaviour is not supported by existing evidence. These results do not support use of genetic testing or the search for risk-conferring gene variants for common complex diseases on the basis that they motivate risk-reducing behaviour.
Beyond that, there’s a simple truth that – for once – did not seem completely lost in the hoopla: Genes are not destiny. They are potential. Whether and how they express is largely a matter of environmental factors and forces – epigenetics – and their impact on the extracellular matrix, or biological terrain. For instance, the LA Times reported,
“It is important that people understand that genetic risk is just one piece of the bigger puzzle,” Jeffrey Shuren, director of the FDA’s Center for Devices and Radiological Health, said in the statement.
One of the major worries with direct-to-consumer testing is that customers could interpret results as definitive answers, said Brent Fogel, associate professor of neurology and human genetics and director of the UCLA Neurogenetics Clinic. In the clinical world, he said, genetic risk is used only occasionally as supportive evidence.
Similarly, over at Futurity,
ACMGG president and geneticist Michael Watson told Scientific American that the testing will confuse many consumers who won’t know how to quantitatively balance genetic risk against other factors such as environmental influences, lifestyle, and health status. He also argues that consumers will probably want follow-up testing in cases where doctors wouldn’t necessarily order it — and insurance companies won’t pay for it…
Image by Webridge, via Wikimedia Commons