As sequencing becomes easier and cheaper, and everyday people become more aware about genomics and their health, capitalism will strike once again with commercial genomic services.
Services like Ancestry.com, 23andme, and DNA Nudge are becoming increasingly popular, but they aren’t without their shortcomings. Are they a net positive for society, or are they bringing anxiety and stress around something we have very little control over?
Outline of commercial services
23andme and Ancestry serve broadly similar functions and are the two main competitors in the health and ancestral history space. Ancestry, unsurprisingly, has a focus on revealing one’s family history, ethnic background etc., but also branches out into health insights. 23andme has health insights as the primary focus of its brand.
Both can offer insights into broad risk categories for particular diseases and have a strong emphasis on personal data privacy. All data are destroyed after testing unless specifically stated otherwise.
DNA Nudge has taken a slightly different market niche. A one-time-use cheek swab is used to look for specific SNPs, relating to nutrition-related health conditions, which are then analysed. Results are loaded onto a small device and a DNA report is uploaded to an app.
The DNA Nudge app does something slightly different from all the generic things we’ve come to expect from such commercial services. The app shows your genetic predispositions and risk levels – red, amber or green – to nutrition and skin-related health traits, and allows you to scan shopping products for personal product recommendations. So, if you scan a particular skincare product that has a link with a known genetic predisposition to, for example, cause a rash, the app will let you know.
The issue of anxiety
While these health insights can be useful and fun, for some it is anything but. One notable story in the news came from Dorothy Pomerantz, a writer from the USA. Dorothy decided to use one of these commercial genomic services for a bit of fun. When using one of these services, Dorothy found out that she was a BRCA1-mutant carrier, putting her at a huge risk for both ovarian and breast cancer. Receiving such dramatic news at home from a test report was a big shock, and led to a lot of upset and anxiety for Dorothy. There was no support, and no additional information other than what she could find on Google. You can read more about her story here.
As these commercial genomic services become more popular, more people are going to find out about their increased risk of breast cancer through an online report as opposed to sitting with a genetic counsellor.
Perhaps one day, these commercial genomic testing services will become more broadly integrated with healthcare systems and genetic counselling services. If it can help people like Dorothy reduce the risk of missing an early cancer diagnosis, that’s definitely a positive. As to how realistic that is in the real-world, only time will tell.
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