Scripps Genomic Medicine, Scripps Translational Science Institute, 3344 N. Torrey Pines Court, Suite 300, La Jolla, CA 92037, USA.
J Med Genet. 2013 Jun;50(6):393-400. doi: 10.1136/jmedgenet-2012-101207. Epub 2013 Apr 4.
There are few empirical data to inform the debate surrounding the use and regulation of direct-to-consumer (DTC) genome-wide disease risk tests. This study aimed to determine the long term psychological, behavioural, and clinical impacts of genomic risk testing for common disease.
The Scripps Genomic Health Initiative is a prospective longitudinal cohort study of adults who purchased the Navigenics Health Compass, a commercially available genomic test. Web based assessments were administered at baseline, short (3 months), and long term (1 year) follow-up.
2240 participants completed either or both follow-ups and a subset of 1325 completed long term follow-up. There were no significant differences from baseline in anxiety (p=0.50), fat intake (p=0.34), or exercise (p=0.39) at long term follow-up, and 96.8% of the sample had no test related distress. Longitudinal linear mixed model analyses were consistent with results of cross-sectional analyses. Screening test completion was associated with sharing genomic test results with a physician (36.0% shared; p<0.001) and perceived utility of the test (61.5% high perceived utility; p=0.002), but was not associated with the genomic risk estimate values themselves.
Over a third of DTC genomic test recipients shared their results with their own physician during an approximate 1 year follow-up period, and this sharing was associated with higher screening test completion. Genomic testing was not associated with long term psychological risks, and most participants reportedly perceived the test to be of high personal utility.
关于直接面向消费者(DTC)全基因组疾病风险检测的使用和监管,目前几乎没有经验数据可以为相关争论提供参考。本研究旨在确定全基因组疾病风险检测对常见疾病的长期心理、行为和临床影响。
斯克里普斯基因组健康倡议(Scripps Genomic Health Initiative)是一项针对购买了商业可及的 Navigenics Health Compass 基因组测试的成年人的前瞻性纵向队列研究。在基线、短期(3 个月)和长期(1 年)随访时进行基于网络的评估。
2240 名参与者完成了任意一次或两次随访,其中 1325 名参与者完成了长期随访。与基线相比,在长期随访时焦虑(p=0.50)、脂肪摄入(p=0.34)或运动(p=0.39)没有显著差异,样本中 96.8%的人没有与测试相关的困扰。纵向线性混合模型分析与横断面分析结果一致。筛查测试完成与与医生共享基因组测试结果(36.0%共享;p<0.001)和测试的感知效用(61.5%高感知效用;p=0.002)相关,但与基因组风险估计值本身无关。
在大约 1 年的随访期间,超过三分之一的 DTC 基因组测试接受者与他们自己的医生分享了他们的结果,而这种分享与更高的筛查测试完成率相关。基因组检测与长期心理风险无关,大多数参与者报告称他们认为该测试具有高度的个人效用。