The Big Day: Your Genetic Profile is Ready at 23andMe!

Small email, big day. On Friday evening, while I'm watching NBC Nightly News, a short and simple electronic message arrives on my iPhone informing me that my genetic profile, hundreds of new data points about my physical being, is available to me online. Now that is news I can use!

I skip the rest of Brian Williams and head to my office in the basement to fire up a web browser. I'm already registered at www.23andMe, that is part of the process for ordering their DNA analysis, so I log in and wait for the page to load. I am greeted with a simple but very powerful message: "welcome to you."

I check the calendar and see that it has been exactly 6 weeks since I mailed a small vial of my saliva from Philadelphia to California for analysis. The results are well worth the wait, they include data about everything from deep ancestry on my mother's side to my tolerance for caffeine.

And I see right away that all of this data is organized with considerable skill. I know a thing or two about the challenges involved in presenting complex, multi-layered data in an accessible manner (like the data involved in testing, targeting, and personalizing million-visitor consumer websites). Also, as many of my friends know, I have strong opinions about user interface design (I have personally appealed to Steve Jobs to put a proper Delete key on the MacBook keyboard).

But the UI at 23andMe works for me. Within 20 minutes or so I am navigating down to the research report that gave rise to the assessment that there is a probability that I might have a genetically-based learning problem. (Yes, there's some irony there.)

Of course, the first thing I check out, and I'm betting this is the case for most people when they get their 23andMe analysis, is Disease Risk. This is one of the 5 main categories into which 23andMe organizes your genetic data:
  • Disease Risk

  • Carrier Status

  • Drug Response

  • Traits

  • Health Labs

I do a quick scan of the 3 subcategories under Disease Risk. These are: Elevated Risk, Decreased Risk, Average Risk. Obviously the first category is going to get my immediate attention. There are a couple of items atop the Elevated Risk list: Prostate Cancer and Celiac Disease. The list is organized into 5 columns: Name, Confidence, Your Risk, Average Risk, and "Compared to Average." The only two items labeled with the symbol for strong confidence are Prostate Cancer and Celiac Disease. As you can see here, compared to average, it looks like I have a 1.12X risk of Prostate Cancer and 3.10X risk of Celiac Disease.

23andMe screenshotThe 23andMe web page lets me drill down to learn more about these diseases, but I already know that, unpleasant as it might be, a. Celiac is treatable with a gluten free diet and b. cereal has been my breakfast just about every day of my life, with no unpleasant side-effects so far. As for my prostate, it seems to be doing okay so far, based on that uncomfortable episode in my recent annual physical.

Of course, I realize that some people who get their DNA tested are going to see some scary stuff in this list. That is why some doctors think the Federal government should ban direct-to-consumer genetic testing, forcing all such tests to require a prescription and requiring a trained medical professional to deliver the results. Apparently, the fear is that some people won't understand what they are reading and will react badly.

Here's a personal perspective on that argument. You currently need a lot more than a prescription to get the kind of test that revealed my thoracic aortic aneurysm 7 years ago. How did the cardiologist inform me of that aneurysm? With a photocopied form letter that arrived at my house on a Friday after their offices closed for the weekend. How many words of advice and counseling about the implications of that test were included: 0.

So I'm not at all impressed with the argument that doctors should be in charge of the flow of information about my genes. (To expand on the above experience, I went to see the cardiologist after getting that letter and was so traumatized by his description of my condition that I quit a very good job in order to reduce stress, only to find out, 6 months later, that in the opinion of a respected cardiologist at the Mayo Clinic, I did not have, and had never had, a thoracic aortic aneurysm.)

But enough stalling Stephen, everyone wants to know what is behind door number one, the Locked Reports section at the top of the list above. This is how 23andMe handles really serious conditions. You have to make an explicit and informed decision to see the results. When you click to unlock the data, in this case pertaining to my genetic risk factors for Parkinson's, 23andMe provides a lot of information about the disease and how it is related to genetic factors. That means you are well-informed and well-prepared before you proceed.

In my next post I will unlock this information and share the results. Why? Because some people will find it interesting? I think the answer goes deeper and wider than that. The slogan of DEFCON III, the hacker convention I spoke at in 1995, was this: "Why? Because we can." And that's the way I feel about learning more about my genes. I can. Why wouldn't I? You might be thinking "His tune will change if he finds something bad in the results." I don't think that is the case, but we will see.

In the meantime, if you want a detailed blow-by-blow of getting tested by 23andMe there is a good account here, complete with pictures and screenshots. Although the author, Paul Stamatiou, is probably half my age, his motives seem very similar to mine. Paul wrote his account about a year ago. From my experience so far, 23andMe has improved in some of the areas Paul thought were a tad "early stage." And the price of the service has dropped considerably in recent months.

Bear in mind, we are only just scratching the surface here. After diseases, there are genetic traits to uncover, then relatives to discover and ancestral links to uncover (teaser: Ursula and Wodan are involved). The next installment of my genetic exploration will be posted shortly.

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