23andMe chief executive Anne Wojcicki wrote an opinion piece saying that people do not need experts to interpret genetic risk reports. She likened the reports to at-home pregnancy tests, which are much simpler to read.
Wojcicki compares the current pushback as the same physicians felt back when the at-home pregnancy test was released.
No Second Opinion
To hit back against critics of the FDA's move to allow 23andMe to sell the first at-home genetic test for an inherited risk for cancer, Wojcicki wrote an op-ed in STAT. In the op-ed, Wojcicki compares the at-home genetic test to the at-home pregnancy test that women use to detect whether they may be pregnant.
23andMe's genetic test analyzes DNA for three specific genetic variants on the BRCA1 and BRCA2 genes. These two genes are linked to an increased risk of breast and ovarian cancers. These variants are mostly found in people of Ashkenazi Jewish ancestry. Women who have just one of the variants have a 45 percent to 85 percent chance of developing breast cancer by the age of 70.
Wojcicki defends the 23andMe genetic cancer test by saying that she believes people should have more direct access to critical information. She cites the studies that have concluded that as many as 50 percent of people with one of the genetic mutations that could show signs of cancer wouldn't qualify for a breast or ovarian cancer screening under current guidelines.
Wojcicki likens the pushback against the genetic cancer test to the pushback by doctors when the home pregnancy test was introduced. Adding that doctors thought that if patients knew the results of a home pregnancy test it would be too much to bear.
Reading The Results
23andMe's genetic cancer test has been criticized for painting an incomplete picture of the risk of breast and ovarian cancer. In a different op-ed on STAT, Susan Domchek, a medical oncologist and associate professor of medicine, outlines the faults with 23andMe's genetic test.
Domchek highlighted the three main problems with the 23andMe tests. The mutations which 23andMe tests for are mostly found among people of Ashkenazi Jewish descent. Domchek says that this makes the test unlikely to be useful for those that aren't of Ashkenazi descent. This creates a problem where the person may still have a BRCA mutation even though the test says the person doesn't have the mutations.
Another reason Domchek gives against the at-home genetic cancer test is that 23andMe's test searches for such a small number of cancer genes. Mutations in other genes can also increase the risk of breast and ovarian cancers. Other genes also put people at risk for cancer. Without testing for those, it gives people a false sense of security.
Domchek's last point is that the 23andMe test does not take family history into account. Despite the test saying someone can be negative, their family history may prove otherwise.
