{"id":467,"date":"2011-08-25T12:08:26","date_gmt":"2011-08-25T16:08:26","guid":{"rendered":"http:\/\/blogs.cdc.gov\/genomics\/?p=467"},"modified":"2024-04-08T11:35:44","modified_gmt":"2024-04-08T15:35:44","slug":"think-before-you-spit-do-personal-genomic-tests-improve-health","status":"publish","type":"post","link":"https:\/\/blogs.cdc.gov\/genomics\/2011\/08\/25\/think-before-you-spit-do-personal-genomic-tests-improve-health\/","title":{"rendered":"Think Before You Spit: Do Personal Genomic Tests Improve Health?"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.cdc.gov\/genomics\/files\/2011\/08\/woman_testtube2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-484 size-full\" src=\"https:\/\/blogs.cdc.gov\/genomics\/wp-content\/uploads\/sites\/20\/2011\/08\/woman_testtube2.jpg\" alt=\"Think Before You Spit- a woman looking at a test tube\" width=\"267\" height=\"144\" \/><\/a><\/p>\n<p>Campaigns against public spitting in the 19<sup>th<\/sup> century were largely driven by concerns about the <a href=\"http:\/\/www.bmj.com\/content\/311\/7021\/1685.full\" target=\"_blank\" rel=\"noopener noreferrer\">spread of tuberculosis<\/a>. However, at the beginning of the 21<sup>st<\/sup> century, spitting seems to be making a comeback.\u00a0 Over the past few years, several companies\u00a0have begun offering personal genomic tests online to the public. There have been famous images of \u201c<a href=\"\/\/www.nytimes.com\/2008\/09\/14\/fashion\/14spit.html\" target=\"_blank\" rel=\"noopener noreferrer\">spit parties<\/a>\u201d, where celebrities are seen filling tubes with saliva to ship for DNA testing. Getting information on one\u2019s genes has been promoted as fun, as part of social networking, and as a basis for improving health and preventing disease.<!--more--><\/p>\n<p>When it comes to spitting to improve one\u2019s health, we say: think before you spit.\u00a0 Our knowledge of the potential benefits and harms of these tests is incomplete at best. \u00a0Despite exciting research advances in genomics of common diseases, there is still much to learn about what this information means and how to use it to prevent disease. A little bit of incomplete or inaccurate information may <a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2362.2009.02232.x\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">even be\u00a0harmful<\/a>.<\/p>\n<p>There are at least 2 <a href=\"http:\/\/www.medscape.com\/viewarticle\/724963\" target=\"_blank\" rel=\"noopener noreferrer\">key questions<\/a> to consider when deciding whether personal genomic tests are worth your spit. First, how well can these tests detect or predict particular health conditions? \u00a0Most common diseases, such as diabetes, cancers, and heart disease, are caused by multiple genes and interactions with environment and behavior. Therefore, a risk estimate based only on genes is bound to be uncertain and can rapidly change based on new information. Different companies may even arrive at different interpretations of the same information. In 2010, a special undercover investigation by the <a href=\"\/\/www.gao.gov\/products\/GAO-10-847T\" target=\"_blank\" rel=\"noopener noreferrer\">Government Accountability Office<\/a> found that tests by different companies of the same samples gave contradictory results. Second, can the test provide additional information that leads to better health? If the test indicates increased or decreased risk for a disease, what can be done about it? Will the test tell us more than what we know to do already?<\/p>\n<p>Many interventions for reducing one\u2019s risk for common diseases&#8211;such as smoking cessation, weight loss, increased physical activity, and blood pressure control&#8211;are beneficial regardless of a person&#8217;s genetic background. In the words of one consumer who responded to the <a href=\"http:\/\/www.medscape.com\/viewarticle\/724963\" target=\"_blank\" rel=\"noopener noreferrer\">CDC podcast on personal genomics in 2010<\/a>:\u00a0 \u201c\u2026seems one should just assume you have many health risks, then take really good care of yourself to lessen risks. Pretend you did the tests. Get \u2018pretend-scared\u2019 straight! You can then motivate yourself to keep healthy weight, exercise, reduce stress, get enough rest, consume healthy foods, avoid unhealthy habits,\u00a0 enjoy hobbies &amp; keep mind active, build friendships &amp; family bonds&#8230;\u201d In fact, new data from CDC\u00a0\u00a0show that people who engaged in four healthy behaviors \u2014 not smoking, eating a healthy diet, getting regular physical activity, and limiting alcohol consumption- had much lower likelihoods of dying (over an 18 year period) from cancer, cardiovascular disease and other causes than those who did not engage in all four healthy behaviors. \u00a0Not smoking provides the most protection from dying early from all causes.<\/p>\n<p>Several scientific studies designed to evaluate the potential impact of personal genomic information on health behavior and outcomes have been published and more are under way. <a href=\"\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2936269\/?tool=pubmed\" target=\"_blank\" rel=\"noopener noreferrer\">Recommendations<\/a> for setting scientific standards and a research agenda for personal genomics were published in 2009 by a panel convened by the <a href=\"http:\/\/www.cdc.gov\/genomics\/\" target=\"_blank\" rel=\"noopener noreferrer\">Centers for Disease Control and Prevention<\/a> and the <a href=\"http:\/\/www.nih.gov\" target=\"_blank\" rel=\"noopener noreferrer\">National Institutes of Health<\/a>.\u00a0 Those <a href=\"\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2936269\/?tool=pubmed\" target=\"_blank\" rel=\"noopener noreferrer\">recommendations<\/a> for scientific evaluation still hold today.<\/p>\n<p>In 2008, Dr Kari Stefansson, a leading scientist in the genetics community and founder of one of the companies that offer personal genomic tests said: \u201cI am convinced that within five years every college-educated person in America is going to have a [genomic] profile like this. You cannot afford not having this.\u201d \u00a0While this prediction may or may not be fulfilled based on the evolving scientific evidence, when a valid and useful test becomes available, the public health imperative is to have such tests widely available,\u00a0 regardless of educational levels or other socioeconomic factors. For example, a recent national survey found that <a href=\"\/\/www.ncbi.nlm.nih.gov\/pubmed\/21358336\" target=\"_blank\" rel=\"noopener noreferrer\"><em>BRCA1\/2<\/em> testing for breast and ovarian cancer<\/a>\u2014which is <a href=\"https:\/\/www.cdc.gov\/genomics\/disease\/breast_ovarian_cancer\/counseling.htm\" target=\"_blank\" rel=\"noopener noreferrer\">clearly beneficial for some women at high risk<\/a>\u2014is underutilized, especially among black and Hispanic women.<\/p>\n<p>A\u00a0very informative and inexpensive &#8220;genomic test&#8221; is available right now: <a href=\"https:\/\/www.cdc.gov\/genomics\/famhistory\/knowing_not_enough.htm\" target=\"_blank\" rel=\"noopener noreferrer\">family health history<\/a>. An accurate, updated family health history can help healthcare providers assess the presence of many genetic conditions and whether patients and their relatives may have an increased risk for specific diseases. Family history also captures shared genetic, environmental and cultural disease risk factors.<\/p>\n<p>We are interested to receive your thoughts about the use of personal genomic tests to improve health and prevent disease.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Campaigns against public spitting in the 19th century were largely driven by concerns about the spread of tuberculosis. However, at the beginning of the 21st century, spitting seems to be making a comeback.\u00a0 Over the past few years, several companies\u00a0have begun offering personal genomic tests online to the public. There have been famous images of<\/p>\n","protected":false},"author":121,"featured_media":484,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5740,5236,5741],"tags":[5739,5726,31856],"_links":{"self":[{"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/posts\/467"}],"collection":[{"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/users\/121"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/comments?post=467"}],"version-history":[{"count":38,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/posts\/467\/revisions"}],"predecessor-version":[{"id":6460,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/posts\/467\/revisions\/6460"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/media\/484"}],"wp:attachment":[{"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/media?parent=467"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/categories?post=467"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.cdc.gov\/genomics\/wp-json\/wp\/v2\/tags?post=467"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}