Great to see some straight talking common sense from the US. Just because you can have your genome dissected, doesn’t mean you should pay a few hundred pounds for your ‘genetic risk assessment’ as several UK and US websites currently offer. These tests may need FDA approval, says this piece from the New England Journal of Medicine (which since a medical student, has been my favourite journal, thanks to the thinness of it’s paper and smell of the ink (sorry, BMJ) )
As they say
“What should happen, for instance, when a 30-year-old man with no relevant signs, symptoms, or family history shows his doctor a genetic test result indicating that he has an elevated risk of prostate cancer? Should his prostate-specific antigen level be measured? An ultrasound obtained? A biopsy performed? What level of risk should trigger further testing? What are the liability risks of not pursuing a diagnostic evaluation? As the number of conditions for screening expands, so will the cost to our health care system and the risk of iatrogenic harm to patients. ” The answer to the first five questions are ‘we don’t know’, incidentally.
For a long time, I’ve been feeling rather alone in talking about the negative impact of screening tests – it’s great to have company.