Friday, April 1, 2011

DTC genetic testing: Caveat Emptor


I met Cynthia in a van from the airport, headed to the annual meeting of Family Tree DNA (familytreedna.com), where I was to speak about genetic testing. A beautiful blonde who looked decades younger than her 60 years, she?d led a painful life, with type 1 diabetes since childhood, just like her father, brother, and grandfather. The family, so they thought, was 100% European, mostly Polish.

My talk did not go over well. Genetic testing companies and their customers do not like to hear that a geneticist thinks their tests should be regulated, for reasons of both privacy and accuracy.

Cynthia, intrigued despite my warnings, sent off a spit sample to 23andme (23andme.com), to learn about her ancestry. She got that, and more ? health information, including a ?lower than average? risk of developing diabetes. deCODE Genetics (http://www.decodeme.com/) gave her the same answer. Ditto her brother.

But her brother?s Y chromosome held an explanation. About 1200 years ago, a Korean man and at least two Chinese men dropped a bit of DNA into the family. So when Cynthia went back to 23andme and recalculated, entering ?Asian? instead of ?European,? her diabetes risk shot up to 90%.

So it looks like ancestry testing helped get this family on the right track. But another way to look at it is that the health-related tests are simply not precise enough.

This past week ?direct-to-consumer? genetic testing took a hit, and it?s about time. First the Walgreen?s near-fiasco of off-the-shelf direct-to-consumer genetic tests, then a white paper from the American Society of Human Genetics calling for oversight of ancestry testing.    To top that off, I got a call from a writer for a popular psychology magazine asking me for a ?sound bite.? A sound bite? Genetic testing isn?t quite that simple.

Genetic tests for well-studied mutations, delivered by a genetic counselor or physician, in person, are fine. But the genetic ?associations? gleaned from population data, although useful in research, often cannot reveal much of anything about an individual ? such as Cynthia.

Caveat emptor. 

[cross-posted from Ricki Lewis' blog, GeneticsWatch.]

Source: http://feedproxy.google.com/~r/WomensBioethicsBlog/~3/B0XOnzGQ0-w/dtc-genetic-testing-caveat-emptor.html

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