I have fascinating genes. At least, they're fascinating to me. For the last several weeks I've been getting up close and personal with my DNA as I compared three major direct-to-consumer genetic testing services. These companies, which claim to identify their customers' genetic predispositions for various diseases, are products of the multibillion-dollar, multiyear effort to map the human genome. It's a place where biotech meets infotech.
To test the services, I signed up for all threeNavigenics, 23andMe, and deCODEme at the same time. Once I registered and paid online, each service sent me a kit to collect my genetic material and a mailer to return it. Navigenics and 23andMe use saliva samples for analysis. DeCODEme has a more involved process, using what looks like a specialized tongue depressor to take a scraping of the inside of your cheek. I was a bit worried about messing things up, but a video on the Web site showed me how to do it properly. To measure response times, I made sure to send back the kits simultaneously.
All three services make results available on password-protected Web sites, along with tools and resources to help interpret them. Navigenics' results focus solely on health and medical aspects; 23andMe and deCODEme both provide ancestry-related information as well. Of the three, the $999 Navigenics service was generally the speediest and did the best job of keeping me posted on the process. Its kit arrived in a week, and my results were ready 11 days after I returned it.
TIPS TO AVOID RISKS
Navigenics covers 27 medical conditions, from brain aneurysms to psoriasis. They're displayed on an easy-to-understand color-coded grid, with orange boxes identifying conditions that may require attention. Clicking on any box plunges you deeper into the results, bringing up detailed explanations of the disease "markers" observed in your genes, tips to mitigate your risk through controlling nongenetic factors, and links to support groups and other resources on the Web. Navigenics also provides a toll-free number for you to discuss your results with one of its licensed genetic counselors. The one I spoke with was excellent. And there are tips and tools for sharing results with your doctor.
23andMe, which counts Google (GOOG) as an investor, was the slowest of the three to report. While the $499 test kit arrived four days after I placed my order, it took 18 days for the company to acknowledge receiving my sample, and another 17 days before it posted results. In between I filled out 30 or so simple surveys 23andMe uses for its own research.
Offsetting the long wait, 23andMe was the cheapest of the three services. And it provided the most interesting (if not necessarily important) information about my results, plus social networking features and other fun stuff.
My results were presented in the form of "clinical reports," as the service calls them, covering 48 diseases, traits, and conditions where the science is pretty well-established. The service also threw in some other "research reports" that are of interest but not meant to be conclusive. The site does a good job of explaining the results, and genetics junkies can dive deeply into how their risks were assessed. Here is also where I learned that only about four pounds of my extra body weight can be blamed on genetics; the other 20 or so pounds are all me.
Unlike Navigenics, 23andMe provides ancestry information, locating you within ethnic and geographic groupings. It also can scour its database to come up with a list of potential relativesin my case, nearly 1,000 of them, ranging from a possible second cousin to others far more distant. Members can message one another—with or without names—and compare genomes or family histories.
RESULTS IN PERSPECTIVE
DeCODEme comes from DeCode Genetics, a company in Reykjavik, Iceland, that filed for bankruptcy protection in the U.S. just as I was signing up for the $985 service. Its kit was the last of the three to be delivered, 11 days after my order. Results were available 22 days later, but only sort of: On the site, every item I clicked on returned a message that "You cannot view further details until a health care provider has reviewed your results." A customer-service representative explained that the service needed a letter from my doctor stating that he was prepared to discuss the findings with me. She pointed me to deCODEme's terms of service. It turns out New Jersey, where I live, is listed as one of 11 states requiring that "a qualified health care professional is involved in the ordering and the delivery of results." The other two services didn't make me go through this rigmarole.
Even after I provided the doctor's note, deCODEme required me to consent item by item before showing me results on 48 different health matters. And I still couldn't get directly to my results; a pop-up window encouraged me to answer several optional questions for research purposes first. Once I finally waded through everything, deCODEme provided an impressive volume of background information to put my health results in perspective. But I found the ancestry information confusing and generic, compared with 23andMe's. The best part was a Facebook-like friend function, where I could troll for and invite other deCODEme users to share information. I felt a little like a DNA stalker.
The findings of the three services, which generally agreed with one other, are undoubtedly more interesting to me than to you. Among things I found out: While Type 2 diabetes runs on both sides of my family, I actually have less of a genetic risk than most people. On the other hand, I have slightly greater odds of developing glaucoma, though there's no family history of it. And, according to 23andMe, I metabolize caffeine faster than most people, which explains why my four-shot Starbucks cappuccinos don't send me rocketing through the ceiling.
If you're thinking there's something just a bit narcissistic in all this, you're right. So enough about me—let's talk about me.
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