Consumer Genetics Will Be the Next Home Pregnancy Test, Says 23andMe CEO
23andMe CEO Anne Wojcicki claims that people using home DNA tests don’t need experts to help them interpret genetic health risk reports, in an opinion piece published in STAT on Monday.
She compares 23andMe’s health reports, which tell people whether they’re at risk of developing certain diseases, to at-home pregnancy tests.
“Forty years ago, when the first at-home pregnancy tests became available, some physicians warned against their use,” Wojcicki argues. “They thought women might not be able to handle such information on their own and claimed that the results might trigger them to make irrational decisions — some went so far as to claim it would lead to suicides. Looking back, it seems unthinkable that we questioned women’s ability to access this kind of information.”
The obstacle to Wojcicki’s claims, however, is how a test for genetic risk is a bit more complicated than a simple pregnancy test.
23andMe’s recently FDA approved BRCA test, for instance, analyses DNA for three of the thousands of known BRCA mutations that indicate an increased risk for ovarian and breast cancers, mutations only common in people of Ashkenazi Jewish descent.
Making those variants its debut test for cancer risk, was a good call — firstly, they’re extremely well studied, and second, women with one of the variants have between 45-85% chance of developing breast cancer by the age of 70. But that didn’t convince genetic experts, doctors and scientists. Some expressed concerns that the test would give people the “false illusion” that they aren’t carriers, when they could, in fact, have any hundreds of known mutations. In addition, it could be complicated if the result would indicate that a person is at high-risk of cancer, too.
In a STAT opinion piece last month, Susan Domchek, who’s Execute Director of the Basser Center for BRCA at the University of Pennsylvania, wrote: “In our clinic, we generally set aside an hour for the initial discussion, with additional discussions over time. The same is true in similar clinics across the country. This kind of discussion and explanation isn’t something you’ll get with your 23andMe results.”
Wojcicki, however, fights her case saying that 23andMe’s cancer-risk test solely expands access.
“Historically, access to this type of testing has been gated by insurance companies and couldn’t be obtained without an order from a physician or genetic counsellor,” she argues. “Making this kind of test directly available to consumers is a huge milestone in empowering people to be in control of their own health information.”
A lot of people expressed scepticism of Wojcicki’s point on social media, but Scripps Research Institute’s Eric Topol, told Gizmodo that he felt Wojcicki’s comparison was apt — arguing that consumers are frequently much more savvy than doctors give them credit for.
“I have some problems with [23andMe’s] BRCA test, since it’s only worthwhile if positive, but it does carry the right caveats and consumers are much smarter than the medical community makes them out to be,” he told Gizmodo. “That’s especially true when it comes to genomics, where doctors are behind and consumers, with a vested interest in their health, can catch up quickly.”
For what it’s worth, 23andMe does encourage consumers to advise a doctor of they receive results that are upsetting.
Citing research and a Nature letter, Wojcicki argues that consumers can handle receiving genetic health risk information on their own, concluding that her company’s risk-tests could be lifesaving for some.
CEO and Co-Founder Anne Wojcicki of genetic testing company 23andMe on how she grew a love for science despite not being the best at it and how she believes everybody can understand science and contribute to changing the face of research, via MAKERS.