Are direct-to-consumer genetic tests the right choice for you?

March 26, 2019 in Health Risk Management  •  By Miles Varn, MD
genetic tests

Over the last five years, pharmacies and websites have offered an increasing number of direct-to-consumer genetic tests. These tests, which you can buy without a prescription, can provide information about a range of health issues, from how well you will respond to a certain type of antidepressant, blood thinner, or other medication and your risk of developing some diseases to the type of diet or exercise that may be most effective for you. Genetic tests that used to cost $100,000 or more are now available for hundreds of dollars. But this easier access to genetic information has both pros and cons you should consider carefully before you use them.

What can and can’t a genetic test tell you?

The most well known direct-to-consumer genetic tests are ones that trace your ancestry. Some of these companies as well as others offer health-related tests. These tests estimate your genetic risk of developing a range of diseases including Parkinson’s disease, Alzheimer’s disease, celiac disease, cystic fibrosis, sickle cell disease, and some types of breast cancer. There are also wellness focused direct-to-consumer genetic tests that are designed to help you choose the most effective diet and exercise regimen for your genetic makeup.

While gathering information that can help inform your medical decisions is valuable and can help you make proactive decisions and lifestyle changes that may affect your health, this type of direct-to-consumer testing can have some downsides. Simply because your DNA test shows you have genes that are associated with a certain disease or health issue, that does not mean you are certain to develop that disease or condition, which can cause you needless worry. Many of the tests look for genes associated with diseases for which there is currently no cure, another source of potential anxiety if you find out you have these genetic mutations. If you have children or plan to, the results of your genetic tests have implications for them as well.

Another issue to consider before using a direct-to-consumer genetic test is how easy to understand the report the company provides is and what support the company provides to help you understand your results. There’s a risk that you may make health decisions based on a misunderstanding of your results. For example, if you take the test for the BRCA 1 and 2 mutations, which can increase your risk of certain types of breast and ovarian cancer and find out that you do not have these mutations, you may feel that your cancer risk is low and you can skip screening mammograms. That decision is based on not understanding that there are other risk factors for these cancers and that recommended screening is still important.

The wiser choice is to talk with your doctor about what role genetic testing may play in your health strategy and undergo testing under the guidance of a genetic counselor who can help you understand the result and recommend what your next steps should be.