DNA Testing: Pros, Cons and Considerations

dna testing considerations hand with vial
As DNA testing becomes more cost-efficient and accessible, more people have begun to utilize it as a tool to diagnose health issues, confirm paternity and plan families, among other uses.
 
Currently, DNA testing is most commonly used for:
  • disease
  • family planning
  • forensics
  • genealogy
  • newborn screening
  • paternity
  • prenatal screening.
Within these broad categories, each individual has his or her own unique personal reasons for undergoing DNA testing.

Obtaining DNA Samples

DNA testing is a simple process which looks for mutations or matches through a very complex system. To obtain DNA, a swab test, known as the buccal smear, collects a sampling from inside the cheek.
 
Other parts of the body can provide DNA samples, including:
  • amniotic fluid
  • blood
  • bone marrow
  • hair
  • saliva
  • stool
  • urine.
At the lab, specialized technicians separate and extract genes, looking for a specific "code" or marker that will provide conclusive answers.

Considerations for DNA Testing

If you are thinking about DNA testing, it is important to learn about the specific procedure, possible results and limitations involved. Here are a few important factors to consider:
  • A genetic marker for a specific disease does not indicate exactly how the condition will progress. An individual might be affected mildly, severely or even not at all.
  • Genealogy testing may also bring to light some disturbing percentages in genetic markers.
  • Implications from results of DNA testing often affect more than one person. This is especially true for paternity cases, and those who are found to be predisposed to specific diseases.
  • Not every test is infallible and a wrong diagnosis or prediction can drastically affect an entire lifetime.

Emotional Consequences

Practitioners are concerned about the way individuals handle the DNA testing results emotionally. This is particularly relevant in the area of disease markers. Most experts recommend that families and individuals seek genetic counseling before making any decisions about testing. Paternity and genealogy cases can also become emotional roller-coasters for all concerned parties.
 
When results are good, it is easy to feel a sense of relief or even complacency. However, if risks are discovered for specific diseases, the resulting stress can take a toll on even the most emotionally healthy person.
 
To help people handle DNA test results in a healthy way, the medical community places emphasis on the term "possibility." It is stressed that:
  • A genetic marker is not a guarantee that anyone will actually contract a disease. The test reflects only a potential for illness.
  • Many conditions can be prevented or delayed by medical intervention or lifestyle changes.
  • Paternity cases must have a result of 99.9% correct to be considered conclusive.

Choosing DNA Testing Centers

Because counseling is such an important part of the process, most doctors will recommend using local DNA testing labs. Individuals now have options that include at home DNA testing. It is important to seek a facility and staff that are trained in specialty testing. Any misstep along the way can produce undesirable or erroneous results.
 
Choosing cheap DNA testing may not provide the expected results. Reports state that there are frequently no post-test explanations, which can leave many consumers confused. In addition, up-and-coming mail-in labs are still under scrutiny pending further studies. A typical DNA testing kit might include only a questionnaire on family history and a swab for gathering samples from inside the mouth. In the case of a paternity suit, this does not meet legal acceptance standards.
 
When selecting a DNA testing facility:
  • Be sure it is accredited and certification is up to date.
  • Be aware that no federal or local oversight is in effect for regulating facilities.
  • Consider a facility which practices double testing to increase the accuracy of results.
  • Choose a lab with an experienced staff to insure accurate results.
  • Understand that the actual number of genes tested directly impacts the results.

Cost of DNA Testing

The cost of testing varies widely, depending on the specific procedure involved and facility selected. Fees usually start at about $50 and can rise dramatically to as much as $2000. For those researching ancestry, costs may vary according to the number of "markers" in place. On average, these fees range from about $100 to $800.

The Privacy Factor

DNA testing raised many serious privacy concerns. Currently, these procedures are considered medical treatment, which allows them to be made available to employers and insurance companies. As yet, no regulations exist to provide protection from prying eyes. Discrimination appears to be minimal, but federal laws are in effect for insurance companies and group policyholders.
 
It is a good idea to inquire about the way your DNA records will be stored and handled. Find out if results from DNA testing labs will be treated as separate from your general medical files. Paying for DNA testing out-of-pocket can help preserve your privacy by keeping your information out of insurance records.
 
Resources
 
Healthywomen.org. (2008). Genetic testing. Retrieved August 26, 2008, from the National Women's Health Resource Center Web site: http://www.healthywomen.org/
healthtopics/genetictesting.
 
Healthywomen.org. (2008). Key Q&A. Retrieved August 26, 2008, from the National Women's Health Resource Center Web Site: http://www.healthywomen.org/
healthtopics/genetictesting/keyqa.
 
Mayoclinic.com. (1998-2008). Genetic testing you can order online. Retrieved August 26, 2008, from the Mayo Foundation for Medication Education and Research Web site: http://www.mayoclinic.com/health/genetic-testing/GA00058.