Predicting the Future of Genetics

Not Ready for Prime Time

According to GeneTests.org, the National Center for Biotechnology Information's online database, genetic testing is available for 2,978 diseases (the majority are clinical tests, while 233 are for research purposes only). Figure 1 maps the exponential growth in available genetic tests since 1993 (seven years before the Human Genome Project was completed).

Continually, new information becomes available about genes associated with particular illnesses. The difficulty lies in putting it into an appropriate context.

"Many NPs and PAs—and probably primary care docs—don't really have a good understanding of genetics," says Ruth McCaffrey, ND, DNP, ARNP,BC, FNP, GNP, Professor, College of Nursing, Florida Atlantic University. "And therefore, they don't want to bring it up with patients, because they don't know how to help people."

A key aspect—before even delving into the specifics of what genetic testing can offer a particular patient—is managing expectations, both patients' and providers'. Genetics holds a wealth of promise for the future, but that future is not necessarily now. Pharmacogenetics, for example, has not advanced as researchers had hoped; while there are instances in which a medication may be selected based on the patient's genetic make-up (think of Alzheimer's disease), the field has not come to fruition yet.

So having genetic knowledge may not translate to useful action. And that leaves a lot of room for frustration and anxiety.