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DIY Doctor
Is Self-Testing a good idea?

By CATHY BREITENBUCHER

March 2014

When the United States Food and Drug Administration ordered DNA testing company 23andMe Inc. to withhold certain results from new customers last December, fresh attention was drawn to the burgeoning home medical testing industry.

The company had crossed the line by providing health-related genetic test results — a big leap from harmless ancestry information, according to Jenny Geurts, a genetic counselor at Froedtert & The Medical College of Wisconsin.

"The test is the same for everyone, no matter what your family history is," says Geurts. "There is misunderstanding about what they are testing for and the limitations of the testing."

Tests that involve a physician, on the other hand, aim to answer specific questions about a patient. Geurts is there to remind patients that even if markers indicate an increased risk of a health problem, "a genetic test doesn’t mean that’s your destiny."

23andMe, founded in 2006, uses a customer’s saliva sample to produce ancestry-related information and raw genetic data. "For $99, it’s a pretty good sell," Geurts says.

But would a person really want to know they are at greater risk for developing Alzheimer’s or Parkinson’s ? Such information could shape a career path or make a person decide against having children, or even contribute to hopelessness or suicide.

"Because you have these markers — ‘When am I gonna get it?’ — that’s a really heavy weight to live with," Geurts says. "These are the kind of conversations I have with people before they have the test. Once you do the test, you can’t ‘unhear’ the information."

Meanwhile, some home tests (pregnancy, HIV and urinary tract infection) give a consumer a yes-or-no result. Others (cholesterol and various hormones) produce numbers within a range — it’s best to report the result to your doctor for interpretation and any follow-up care.

"Most tests aren’t that definitive," notes Dr. Roy Silverstein, professor and chair of the department of medicine at Froedtert & MCW. "One of the biggest dangers is that a normal test result creates the impression of a get-out-of-jail-free card for an unhealthy diet and lifestyle."

The Cost of Testing

Unlike a test ordered by your doctor, a home test might not be covered by insurance. Here are the out-of-pocket costs for some popular test kits (one test per package unless noted).

Ovulation and fertility —$35-$40 (20-30 tests)

Pregnancy — $3

Drugs (amphetamines, marijuana, cocaine, methamphetamines and opiates) — $8-$20

DNA paternity — $27 plus $129 lab fee

Alcohol — $13 (5 tests)

HIV — $40

Urinary tract infection — $13 (3 tests)







 

This story ran in the March 2014 issue of: