In recent years, the market of personalised genetic testing has emerged thanks to cheaper sequencing techniques. Some companies now offer genetic tests at an affordable price (£125 on www.23andme.com). All that is needed is a mouth swab that can be done at home. Send the box by post and receive the results within a few weeks. Find out about the probability of you developing diabetes, hypertension and dementia and take measures to prevent these diseases. Find out now whether you are one of those unfortunate people who will develop Huntington’s disease in their late years and plan your life accordingly. Why is this technique not used in any healthcare system yet? What are a hundred pounds compared to all the benefits promised by this test?
First of all, how reliable are the predictions made by the test? Given that we are dealing with increased risks, what is their magnitude and reliability? The genetic risks have been calculated in an initial population. Will they be the same in a new population? We should not remember that we are talking about predisposition and that in no case does one genetic variant always cause a disease. Secondly, once I know that I am at risk of diabetes, will I change my behaviour and lead a healthier lifestyle? Shouldn’t everyone eat healthily, exercise, avoid smoking and drink alcohol in moderate amounts? After all, healthy habits are beneficial for everybody. A recent study has shown that communicating genetic risks of disease does not reduce risky health behaviour (Hollands et al.). What is more, if a risk of incurable disease is communicated, like in the case of Huntington’s disease, imagine the unnecessary distress and sense of powerlessness that you might suffer. Thirdly, in case you are more sensitive to a drug but your healthcare system does not deal with it, what can you do with that information? Most healthcare systems in the world do not even take into account sex and weight when administering drugs, let alone genetic sequence. They do, however, adapt the treatment of breast cancer patients or leukaemia patients to their genome because the evidence of the genetic influence is very strong. Finally, do you really want to give your genetic code away? Isn’t your genetic code something special, that belongs only to you and should not be breached lightly? If you have no issue with disclosing your blueprint to anyone, what about sharing it with a health insurance company? Wouldn’t it be risky to leave your genomic sequence out there, prone to being stolen? One must admit that the probability of your data being disclosed to a health insurance company is higher than a health insurance company stealing a bit of you and sequencing you without your consent. In Switzerland and under certain conditions, health insurers can demand the results of a genetic test to be disclosed only if a test has already been carried out. In no case can a health insurance company demand from a patient to carry out a genetic test (Federal Law on Human Genetic Analysis, 2004). In case an insurance company discovers you are at a higher risk of certain diseases, they will want to charge you more for an insurance or will add reserves in the contract. It is in your interest to not deal with your genetic sequence lightly.
In conclusion, you need to ask yourself all these questions before going ahead and getting sequenced. If you deem the advantages to be higher than the downsides, then get yourself tested. I, personally, wouldn’t.

Cristian Riccio

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