If Your Doctor Could Tell You That You'll Get Breast Cancer, Would You Want to Know?

Counsyl, a Silicon Valley company that screens prospective parents for their risk of passing on rare inherited diseases, has expanded its genetic testing service to assess your inherited risks for breast, ovarian, prostate, and pancreatic cancers.  The expanded testing, which arrived on the heels of $28 million in new funding raised from Goldman Sachs and others, comes in the midst of a national discussion over the proper role of genetic testing in preventative medicine.  Counsyl’s take is summed up by its new tagline — “It’s good to know.” But is it?

Ramji Srinivasan, Counsyl’s co-founder and CEO, says the company’s focus on involving doctors both before and after the test mark an improvement over some of its rivals. After receiving test results through the company’s website, patients are given the option to talk to a licensed counselor. “We think it’s important for anybody to understand this kind of vital information,” Srinivasan says. “But we want them to have the appropriate context and care during the process.”

The question is what constitutes appropriate context and care. There’s still no real consensus about which populations should submit themselves for genetic screening, how those results should be presented, and what actions patients should take as a result. “This is one of the biggest issues in thinking through how we’re going to translate all of the information coming from the mapping of the human genome into clinical and public health practice,” says Barbara Koenig, a professor of medical anthropology and bioethics at the University of California at San Francisco. “How to avoid doing it prematurely. How to do it thoughtfully. How to enable people’s real choices. How not to cause harm.”

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