What 23andMe, Ancestry.com kits arent telling you about your health risks – austin360
Posted: January 25, 2020 at 11:48 am
Lets say, for the holidays, you got a kit from Ancestry.com, 23andMe or a similar company to send in your DNA (aka your spit) and discover your roots as well as your personalized health report.
You spit, you send it off, and youre starting to get the results back.
And in that personalized health report, theres an indication for an increased cancer risk, or theres no indication of an increased cancer risk ... now what? Can these reports be believed? Should you go running to find the nearest doctor to prevent your impending death?
Gayle Patel, a certified genetic counselor and the director of the Genetic Risk Evaluation and Testing Program at Texas Oncology, wants people to know these tests arent looking at the whole genome. Theres a limit to what it can do, she says, but they might come up with some interesting health traits, as well as your long-lost ancestors.
Some of the mysteries they can solve, such as whether there is a genetic reason you prefer chocolate or vanilla ice cream, can be fun, she says. But its not telling the whole story.
If results from one of these tests show an increased risk for something, she recommends bringing that information to your doctor at your next appointment. Its not that you have a disease but that you may have an increased risk, she says.
Your doctor will want to assess what the risk is, how accurate it is and what preventative steps you might want to take, she says.
These boxed ancestry/DNA tests dont have the experts who can personalize the test for you based on your medical and family histories. They also dont have a person explain it to you and make a plan for you.
It can be difficult and scary, she says, to get these results. None of this is destiny or fate. Its talking to you about personalizing your medical care.
Her bigger concern is not that these tests are going to find a risk; its that they wont find a risk and you will think you are fine and not do the usual preventative treatments or recommended screenings.
For example, about a year ago, 23andMe added some of the BRCA mutations to what it looks for. BRCA mutations indicate a risk for breast cancer and ovarian cancer. Patel says this test now is looking at only three of the mutations when there are thousands. Weve had patients who think they have tested negative for that type of cancer when its not true.
Instead, based on personal medical history and family history, shell recommend doing a medical-grade test in an office that specializes in genetic testing to get a comprehensive look at all types of cancer risks.
Were either going to confirm or make sure were not missing something else that can be just as important, Patel says.
Medical testing has gone down in price, and this kind of genetic testing now can be done for about $250, she says, which is about the price of the 23andMe or Ancestry.com kit that includes health DNA. Often, based on medical history, insurance will cover the medical tests.
Patel also wants folks to realize that only about 5% to 10% of all cancers have a known genetic component. Of course, it depends on the type of cancer. Ovarian cancer has about a 23% genetic link, she says, but lung and cervical cancer tend to be more environmental and less likely to be genetic.
New gene mutations are being discovered all the time as more and more data is collected, and what genetics counselors can test for changes all the time, too.
Patel also recommends reading the fine print of where your DNA data is being stored by these companies. Who owns the data, and how is the data being shared? It might be going to a database accessed by pharmaceutical companies for research on new cancer treatments, or it might be on an open database accessible to anyone. As long as they are informed and educated, she says, then these tests are OK. Learn before they spit.
As well, be prepared for the results you might get, such as a long-lost brother or that your father isnt your biological father. It could be one of these surprises that could change how you think about your family, she says.
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