Genomic Medicine: Myth vs. Fact

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Robert Wildin, M.D.

With Robert Wildin, M.D., associate professor of pathology and laboratory medicine and pediatrics and associate medical director of genomic medicine

In select primary care offices in the University of Vermont Health Network, patients may now undergo genetic testing that identifies differences in an individual’s DNA that make certain diseases such as cancer and heart disease more likely. But what are the goals of the service and how do patients benefit? Robert Wildin, M.D., associate professor of pathology and laboratory medicine and pediatrics and associate medical director of genomic medicine, dispels some myths about genomic medicine.

Myth: When you undergo genetic testing you can find out definitively if you are going to develop cancer or heart disease.

Fact: Genetic testing identifies differences in an individual’s DNA that make certain diseases such as cancer and heart disease more likely. The genetic testing currently being offered at UVM Medical Center screens for 147 genes associated with inherited cancer and cardiac risk. If you have a positive result, it means that you have an increased risk for having or developing these conditions – it is not a definitive diagnosis or prediction. This test does not identify all inherited causes of cancer or cardiac risk, and it does not test for things in your environment that may contribute to anyone’s risks, like smoking, diet, and exposure to certain chemicals. However, it can reveal important inherited risks in a small fraction of tested persons, allowing them to start screenings earlier and take other cancer preventing measures. Removing the advantage of stealth from inherited conditions can make for better health.

Myth: Your personal health information could be compromised when you take the genetic test.

Fact: Results of genetic testing are protected in your medical record, along with the rest of your medical information. Since this test is a clinical test, the results are stored in your health record and are protected by health information privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA).

Myth: Genetics is the key determinant in your health and longevity.

Fact: Genetics influences your overall health and longevity. But it is not the only factor. Lifestyle choices, socioeconomic issues and even where you live can play a role as well.

Myth: What’s the point of undergoing genetic testing when you can’t change the results?

Fact: The overall aim of the genetic testing currently being offered is to provide patients with information linked to established treatments. The Genomic DNA Test results focuses on DNA differences that we know are medically important. A potential benefit is that this test may identify genetic causes of a health problem, or show increased risk of certain diseases for you that could also be a risk for your family members. This may help your health care provider recommend care that will keep you as healthy as possible. For example, results might show a genetic cause for high cholesterol. Your provider may then prescribe the cholesterol-lowering medicine that decreases your chance of an early heart attack or stroke. If a genetic health risk is identified, testing will be offered to family members who may also have inherited the risk.

Myth: This is just one way to make health care more expensive.

Fact: The goal of the Genomic DNA Test, when used appropriately, is to help prevent future disease, when it would be more expensive to treat and harder to manage by finding disease processes before you become sick, and preventing the damage they cause through interventions and lifestyle changes.

What are your thoughts about this topic?