New Yorkers can now get a genetic test without going to a doctor's office — but is it worth the $199 price tag?
Google-backed genetic testing firm 23andMe won FDA approval for its at-home kits in October, but it wasn’t until late last Friday that New York’s Department of Health cleared it for sale without a doctor’s involvement.
Though the original test marketed by 23andMe covered 254 potential health issues, it had to narrow its claims to 36 hereditary conditions that could be passed on to children to gain the FDA’s blessing.
The new test also covers three other categories of information such as ancestry, traits such as the likelihood of male pattern baldness and lactose intolerance, and general wellness information like muscle type and caffeine sensitivity. In all, about 60 conditions are currently covered in 23andMe’s report, which the company says will grow with science’s understanding of the human genome.
But unless it turns out your father is not the man you call Dad, there aren’t likely to be any surprises.
“If you wanted to spend money on something — say, $200 for a gene test — spend $200 to join a fitness club,” recommends Dr. Arthur Caplan, a professor of medical ethics at NYU Langone Medical Center.
Unless you’re having a baby, have family history of a specific disease or are receiving treatment for cancer, which has begun including genetic typing of tumors, there’s a reason genetic testing is not a routine part of medical care — yet. Caplan describes genetic test results as a “fire hose” of information, most of which medicine hasn’t decoded. (23andMe’s test is estimated to account for less than 1 percent of the genetic information contained in DNA.)
Not to mention that “many of the things that they might find you at risk of getting, all you need to do is change your lifestyle, because that’s about all we know how to tell you to do.”
One of the reasons the results of a genetic test should be interpreted by a professional is the results may seem much more alarming without understanding the math.
“Let’s say you’re three times as likely to be at risk as the average person of having a horrible kind of brain tumor, but it may be that that brain tumor only strikes 1 in 10 million people," Caplain posits. "So you go from 1 in 10 million to 3 in 10 million. So relatively speaking, you’re not at much risk of it."
Caplan emphasizes that high risk for some doesn’t mean there’s no risk for those without a gene — skin cancer can happen to anyone, and the recommendations to cover up and wear sunscreen are the same whatever the test results say. Genes are just part of a person’s risk profile: Lifestyle and environment have a role to play, sometimes a much more significant one.
Knowing can also have its pitfalls. If the test finds you are at risk of developing a rare condition, it may make it harder for you to buy disability or life insurance, which is not included under the Affordable Care Act’s pre-existing condition coverage mandate.
“Americans are too obese, they drink too much, they don’t wear their seatbelts, they engage in risky sex — these are all things you can control without a genetic test,” Caplan points out. “The big risk factors are environmental or behavioral, they’re not genetic.”