We are living longer in North America. If you can avoid getting in a car accident or
dying from some violent encounter like being shot, you
have a better chance of living longer in the US and Canada than any other
industrialized country. This is good
news, IF we can live longer in good health but how do we manage that?
23 and Me founder Anne Wojcicki offers up a compelling case
to achieve ‘Healthy at 100’ (23 and Me’s Mission). In the recent
issue of Fast Company she promotes the personal and humanitarian benefits
of participating in genome testing. For
$99, 23 and Me offers a fascinating opportunity for individuals who want to
understand the impact that their DNA has on their risk for certain illnesses and,
as I wrote last December in The
Risks and Benefits of Making Genome Data Open and Free, the genome holds
great promise for individuals who want to manage their health.
The challenge for individuals adventuring down this road is
understanding what an increased risk means in the context of many other factors
that impact health. Our health outcomes,
including how long we will live are determined as much by our genetic
inheritance as our behaviours and many factors outside of our control. There is
no certainty in DNA testing, only a quantified level of risk.
Will DNA testing tell me more than what I already know from
the health history contained in my family tree?
My father, a type one diabetic,
died in his early sixties. He lived his
life with an understanding of the toll diabetes would have on his everyday life
and his life expectancy. He watched his
younger sister succumb to the impacts of her poorly managed diabetes and he
lived his life with tightly controlled behaviours that allowed him to travel
internationally, run a successful business and live to see six grandchildren
come into the world. He often declared ‘I’m
the healthiest man in this house’. And
he was.
My mother, on the other hand, is the antithesis of the Public
Health poster child. She is fond of
processed foods, wine and coffee. She
started smoking long before I was born and doesn’t exercise. She will turn eighty in a few months and
other than some calcium supplements and cholesterol medication, she is illness
free, active in many social circles, cognitively sharp and very happy.
In me is a random combination of mom and dad’s genetic
legacy combined with behaviours that emerged from growing up with their influences. There was no obvious health history that would have alerted my doctor or me to a melanoma diagnosis that
took me by surprise twelve years ago. But could there have been a warning in my DNA?
According to 23 and Me, one in 71 Americans develops
melanoma over a lifetime. Genetics are thought to account for some of the
variation in risk of skin cancer, though estimates vary widely. While there is cancer in my family tree,
there isn’t in my immediate family, I was the first and so far the only one who
has had a melanoma diagnosis. If DNA
testing had been available 15 years ago, it may have alerted me to an increased
risk of melanoma and motivated me to engage in preventative screening.
What gems of genetic risk assessment are waiting for me and am I ready to hear about them? I say 'Carpe Dieum', seize the day, the future is
unforeseen and one should do all one can today to make one's future better. One day that may include DNA testing by 23 and
Me but not today.
Your health. Your
information. Manage it well.
