Do at-home genetic tests work?

At-home genetic tests can reveal a wide range of information that can impact your life in different ways. You might find out you’re sensitive to caffeine. Or you may be told you are at higher risk for cancer.

But just because these tests are convenient and can reveal interesting information, does that mean you should try them?

Before you spend money on a test for yourself or someone else, get all the important details from genetic counselor Sara Wofford.

How is at-home genetic testing different from testing done by a health care provider?

If you seek genetic testing in a health care setting, you will first meet with a genetic counselor or other health care provider to discuss your family medical history. You will be asked what you hope to learn through genetic testing, and your genetic counselor will order the best tests for you. A blood or saliva sample will be taken from you in the office or collected by mail. Your genetic counselor or physician also can assist with billing your insurance for all or some of the cost of the testing.

At-home genetic tests do not require a health care professional to be involved. As a result, they do not offer a wide range of tests. You might not be able to get detailed testing for health risks like cancer. Usually, you place an order online directly with the testing company, then they mail you a saliva testing kit.

Another kind of test is physician-ordered online testing. This typically means you buy a test kit from a testing company that has doctors on staff to order your genetic test for you. Tests that fall in these second two categories are usually not covered by insurance.

Should you choose at-home genetic testing over testing through your doctor?

People who want genetic testing to learn more about their ancestry, family relationships or unique genetic traits like caffeine sensitivity or other nutrition needs are best served by at-home genetic testing. These tests are generally not offered in hospitals or doctor’s offices.

People who want genetic testing to learn if they are at risk for serious health conditions like heart disease or cancer should meet with a genetic counselor or a health care provider who specializes in genetics. Some at-home genetic testing kits that advertise testing for cancer risk are actually extremely limited. They may test only for a small number of risk factors, and it can be difficult for patients to determine which test is most appropriate. If you meet with a genetic counselor, they can help ensure that your goals for genetic testing are met.

Some other things to be mindful of before doing at-home genetic testing are:

• Tests that reveal your ancestry and/or family relationships may uncover unexpected information about your family. Some people have found out that they have a different biological parent than they were raised to believe, or to discover a half-sibling they never knew existed. While this is not typical, it happens more often than people expect and is something ancestry test-takers should prepare for.
  
  
• Genetic testing can uncover life-changing health information. Some people who take a hereditary cancer genetic test may learn that they have a very high risk for cancer, which requires an intensive screening schedule for the rest of their lives and/or risk-reducing surgery. If you don’t see a genetic counselor before undergoing testing, you could be caught by surprise if a life-altering result comes back.
  
  
• Many people have significant concerns about privacy and genetic testing. Patients interested in genetic testing should discuss these concerns with a genetic counselor if possible. It is good practice to be careful with whom, and which companies, you share your genetic information.

What can an at-home genetic tests tell you about your cancer risk?

This really depends on the test. Some at-home tests offer what they call BRCA testing for breast cancer risk, but they only test the three variants in these genes that are commonly seen in the Ashkenazi Jewish population. This test is generally not useful for people without this ancestry.

Other genetic testing companies offer comprehensive hereditary cancer testing. If a mutation is found, your test report will give you information about that mutation, including where it is in the gene and how that may impact your cancer risk. You may be able to learn more and discuss your personalized cancer risk by sharing your test report with a genetic counselor.

What information is left out when you get at-home genetic testing for cancer?

For some people, at-home genetic tests provide false reassurance because they only test a limited number of genes. If your test only looks at the three mutations found in the Ashkenazi Jewish population, like many at-home tests do, it won’t tell you if you have a different BRCA mutation or a mutation in a different gene that could impact your cancer risk.

The test also won’t be able to make personalized cancer screening recommendations that account for your family history and your test report. This is something a genetic counselor can help with.

What should you do if your at-home genetic test results show you are at higher risk for health problems like heart disease or cancer?

Before you do an at-home genetic test, make a plan for what you will do when your results come back. If your test reveals that you are at risk for cancer or other serious health conditions, it’s important to meet with a genetic counselor discuss your test results and how to manage your risk.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.