Hacker News Reader

Comment by maratd | Hacker News Reader

There are really 3 sets of results they provide.

1. Genetic disorder. Tay–Sachs, etc. This stuff is priceless, because in the past, you had to pay thousands of dollars to get these same tests tone. These are accurate and very worthwhile ... but the majority of people will come back with all negative results, which is actually a good thing.

2. Your "increased risk" to certain diseases, like heart disease, etc. IMHO, these aren't worth much. A substantial portion of the risk for these types of diseases is related to lifestyle, so take it with a grain of salt.

3. Fun info, like telling you your eye color, where your ancestors came from, etc.

> why are their tests not being subsidized by insurance companies.

Insurance companies really only want #1. And guess what? That's info that I really don't want them to have.

View on HN

There's also

4. You're (nearly) immune to an infectious disease. It's good to know when a friend is puking their guts out that I can help take care of them since I'm one of the lucky 20% of white people with wonky fucosyltransferase that won't act as a receptor for the virus.

And knowing (2) lets channel potential anxiety about salt consumption into anxiety about fat consumption, letting me stay healthier on a given anxiety budget.

For #1 if you have any Ashkenazi Jewish blood or suspect you do, it's really worth it for peace of mind. A lot of people say they don't get interesting results, but as someone who is 25% Ashkenazi I was pretty happy at the lack of "interesting" findings- to find I carry only a minor form of hemophilia among the Ashkenazi-related genetic disorders 23andme tracks.

"This stuff is priceless, because in the past, you had to pay thousands of dollars to get these same tests"

You still have to pay thousands of dollars if you need the results for actual medical purposes. 23andme only tests for a few of the common SNPs that can cause each disease, but the testing isn't as comprehensive as what you'd get from a doctor.

Actually there is a startup called Counsyl that tests for about 1000 of those genetic diseases for about $350. I think you have to get it through a doctor though.

> A substantial portion of the risk for these types of diseases is related to lifestyle, so take it with a grain of salt.

In the case of cardiovascular disease specifically, one might not want to do that.

Yes , but wouldn't Nbr 2 in itself be worth a lot if the patient would make lifestyle changes in response to increased risks highlighted in their genetic profile. Suppose you have a genetic proclivity for alcoholism, wouldn't most people watch their consumption a lot more if provided with that information.

But if one is predisposed to alcoholism, they might think, "Why even try to fight it? I'm going to succumb at some point anyway, might as well give up now and just enjoy it."

This is just to say that that sword has two edges.

EDIT: Made it abundantly clear that this is not my own personal fatalistic perspective.

yours is a fatalistic perspective. I would change my behavior if I knew.

This is clearly not my perspective. I'm just illustrating the opposite viewpoint of the one you espoused for the purpose of reminding you that there is an unhappy alternative viewpoint.

predisposed: make someone liable or inclined to a specified attitude, action, or condition.

Just because you're more inclined to do something, doesn't mean you're likely to do something. See the other comment about a 50% increased likelihood moving someone from 1% to 1.5% risk of succumbing to alcoholism.

That said, a lot of people may make the same mistake and succumb to alcoholism erroneously based on the tests.

What you are saying is so true that it becomes almost irrelevant to the discussion. Or, rather, if people understand what you are saying then the rest of the discussion is moot. So the discussion is premised on the fact that many people don't have enough statistical understanding to consider things through that lens.

Let us assume that the absolute risk is non-negligible, and that the predisposition is also non-negligible. Even then, the way that an individual responds to knowledge of genetic risk is idiosyncratic. Some will fight the predisposition even harder, others will succumb even quicker, still others won't know or care.

Because we are talking about the psychology of the individual, and because people do not understand statistics, much less the difference between absolute and relative risk, the fact that the absolute risk for virtually every disease is very small will not matter when an individual considers the issue psychologically.

Oh, ok. Like the other commentor, I took your original comment as a serious argument.

Let's go with your example. Let's say you have a 50% increased risk of alcoholism than the average population.

What does that mean?

If the probability of alcoholism is the general population is 1% ... well, that means yours is 1.5% ... or still ridiculously small.

Obviously those are just numbers I'm using to illustrate a point, but you see where I'm going with this.

While I agree with your general point, the lifetime prevalence of alcohol dependence is rather high; it is estimated to be 12.5% [1].

1 = http://www.ncbi.nlm.nih.gov/pubmed/17606817

"The heritability of prostate cancer is estimated to be 42-57%." My chance of prostate cancer is 25% instead of 17% for baseline european-ancestry males. I eat even more fruits and veggies and avoid animal fats now.

Category 2 appears to be worthless for me. For many of the risks there, I have conflicting results (i.e., 5 studies were done on this disease and according to 2 of them, I'm at increased risk while the other 3 indicate that I'm at decreased risk).

Reply on news.ycombinator.com