Is home DNA made for adoptees?

Does home DNA testing help adopted patients find out what diseases lurk in their family history? Dr. Brian Goldman has his doubts.

When you seek medical care, it's routine to be asked what diseases run in your family…something nearly impossible to answer if you're adopted.  To bridge the gap, some have turned to home DNA testing.  It's a subject that fascinates me because my two children were adopted from Russia.

Companies like DNA Testing Centres of Canada offer fairly comprehensive genetic testing.  It's not home testing you make an appointment at one of their facilities across the country.  It's fairly pricey; when I visited their web site, they offered testing for specific health conditions, genetic carrier testing, diet and fitness testing and drug response testing for a combined price of $1289 plus HST.  

A handful of companies offer home testing.  23andMe, Ancestry, and Family Tree DNA all give ancestry results.  Only 23andMe gives both ancestry and health testing – at a cost of $199 Canadian.  When you get the kit, you collect a sample of your saliva and send if off.  It takes a few weeks to get the results.

If you sign up for the service, you will receive information on traits like hair and eye colour, lactose intolerance, sensitivity to alcohol, and your overall athleticism.  As far as health is concerned, you are tested for 53 inherited conditions.  They include cystic fibrosis, sickle cell anemia, Tay Sachs disease and others.  They also tell you if you have genes that put you at risk for Alzheimer's, Parkinson's, breast and ovarian cancer and many other conditions.  They also test your genome for how well you are likely to respond to a variety of prescription medications – including blood thinners, drugs for cholesterol as well as epilepsy.

Testing for inherited conditions like cystic fibrosis is basically cause and effect.  If you have the gene, you will get the disease to one extent or another.  When it comes to testing of genetic risk factors, the interpretation is less clear.  Genetic testing may show that you are at increased risk of Alzheimer's or heart disease, but getting the disease may depend a lot more on your lifestyle habits.  On its web site, 23andMe says it can give you a glimpse at your biological parents' DNA simply by showing you your own. While 23andMe does reveal some genetic information about genetic variations that have been associated with diseases and conditions, it is not a substitute for a family medical history.

Experts say it's important to know your family's medical history.  The U.S. has been all over this for some time.  In 2002, the Office of Public Health Genomics started the Family History Public Health Initiative to increase awareness of family history as an important risk factor for common diseases like cancer, heart disease, and diabetes, and to promote its use in reducing the burden of these diseases in the U.S. The initiative conducts research to define, measure, and assess family history in populations and individuals, develops and evaluates tools for collecting family history, evaluates family history-based strategies, and promotes effective applications of family history to health professionals and the public.  My sense is that Canada lags behind the US in harnessing the power of family history in dealing with major public heath issues.

My daughter is interested in getting tested, and my son is thinking about it.  The doctor in me knows that the hype has outstripped its usefulness.  The parent in me understands the urge to know more. As provinces move towards open adoption, there's greater access to birth family medical histories.  But these provisions are relatively recent, and plenty of middle age adoptees have little if any medical information.  In the event of a severe illness,some provinces help locate and contact a birth family member to share medical information that can help with diagnosis and treatment.

Short of that, there are enough obstacles to finding out about the medical history of your biological family to make me think more not less adoptees will get their DNA sequenced in the months and years ahead.


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