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Genetic testing is becoming commonplace. With the advent of new genetic testing companies, what does the future hold for diagnostic testing? Many Direct-to-Customer (DTC) genetics testing companies offer mail-in saliva test kits, similar to the first mail-in AIDS tests offered in 1986. Companies such as 23andme and Navigenics are offering a DTC tests for SNPs (single nucleotide polymorphisms), single mutations on the DNA backbone that may be linked to certain diseases. In addition, genetic tests for bipolar disorder and schizophrenia are coming on the market offered by Psychnomics and SureGene, respectively. Other tests for Alzheimer's may be coming as well. However, the tests do not offer 100% predictability. How will these future tests, the Genetic Information Nondiscrimination Act, and the interaction with patients, DTC genomics testing and healthcare providers come into play? Will genetic tests become as routine as blood tests?

The Genetic Information Nondiscrimination Act
An important bill was passed last year, the Genetic Information Nondiscrimination Act of 2007. In many ways, this bill opened the door for mass production of genetic testing, as it outlawed discrimination against individuals by health insurance companies and employers. This law grows out of the early sterilization laws in 1907-1981 that protected persons with genetic defects. Sickle cell anemia was one genetic disease that threatened discrimination against African Americans. One example of pre-employment genetic screening and discrimination was used at Lawrence Berkeley laboratory in California. This case resulted in a decision in favor of the employee. The Genetic Information Nondiscrimination Act has helped to protect the public from genetic discrimination and aims to allow consumers access to genetic testing and early detection of disease.

One SNP or the Whole Genome?
DTC genomic testing companies are not only offering a test for a single gene, but claim to be selling tests for a personal genome. In early 2007, the company 23andme started a new company based on a "personal genome web-based service." The company was started by executives of pioneering companies in gene testing. Similarly, Navigenics offers, a "gene roadmap to health." Curious about their services, in particular the issue of privacy of genetic information, I read their websites and contacted Navigenics. From the website information and response, it seemed that the customer service and privacy was of more concern to Navigenics

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