This week, the Food and Drug Administration granted approval to test kits capable of determining your risk of cancer.
The kits from genetics testing company 23AndMe work similarly to those popular AncestryDNA tests you might see, where participants send a saliva sample to the company and wait for results.
Is this something anyone worried about getting cancer should consider? USA TODAY chatted with Huma Rana, the clinical director for cancer genetics and prevention at the Dana-Farber Cancer Institute in Massachusetts.
Answers have been edited for brevity and clarity.
Q: Would you recommend this test to patients?
A: No, this is not the kind of test I would recommend for your average person at risk. Specifically, what they've gotten FDA approval for is the testing for the three founder mutations in BRCA 1 and 2 that are more prevalent in individuals of Ashkenazi Jewish descent. Your average patient who is not of Ashkenazi Jewish descent is not going to benefit from having this testing.
We also know that 10% of people who are of Ashkenazi Jewish descent and have a BRCA 1 or 2 mutation don't have one of these founder mutations. There's thousands of mutations in BRCA 1 and 2. They can have a different mutation, and this test is only looking for the three common mutations that are present in individuals of Eastern European/Ashkenazi Jewish descent.
It's really important people understand who the testing is for. There's a lot of misunderstanding of what the test is. The fear I have as a cancer geneticist is that people will be doing this testing and thinking that they're "off the hook" when it comes to breast cancer risk or that their family doesn't have an inheritable predisposition to cancer, when in fact they do because they haven't fully understood what is being tested and it hasn't been put in the context of their personal or family history.
Q: For someone who gets these results and they are positive, what does that mean?
A: It means that individual has an increased risk for developing certain types of cancers, they can develop those cancers at earlier ages of onset, and they need specialized management for their cancer risks. It is not, however, a guarantee they will develop cancer. The mutations in these genes really translate into an elevated risk — and it's a substantially elevated risk — but it's not a guarantee.
Q: How would you advise patients the best way to process these results?
A: There is a lot that goes into how we follow people. The positives in many ways — there are national guidelines that are followed in terms of what should be done, and what interventions or screenings should be done. For the negatives — the reason we keep coming back to the negatives is that they are the ones where having a thorough family history is really helpful in coming up with personalized recommendations for that person or family based on the patterns of cancers that we have seen in the family. Even in families with positive results, there are certain screenings we offer that are based specifically on whether or not there's a family history of that cancer. What's in the press about BRCA1 and 2 is the risk for breast and ovarian cancer, but there are other cancers that are associated with having a BRCA mutation. So for men, prostate cancer, as well as a modestly increased risk for pancreatic cancers.
Q: How prevalent are these types of take-home tests?
A: There is a study currently being done, the BFOR study, which is doing exactly this. There are sites all across the country where this exact thing is being evaluated, and it's for the founder mutations in BRCA 1 and 2. There's also other companies that offer even more comprehensive cancer genetics testing for about the same cost that do it through online platforms.
I think there is some value in all of this. We know that genetic testing is not as accessible as it should be by people who should be having it — who are at increased risks for having these mutations. Genetics needs to be more available to more people. That is clear to all of us. It's just a matter of people understanding what they're signing up for and making sure there's not a misunderstanding or people are not being misled into thinking they don't have any risk.
Follow Brett Molina on Twitter: @brettmolina23.