Are Genetic Tests Useful Part 4

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"We welcome responsible regulation," said David Agus, an oncologist at Cedars-Sinai Medical Center in Los Angeles and the co-founder of Navigenics. "There needs to be medical standards and a system for validating this information."

Feero agrees. "We have relatively little oversight for this information, which you're seeing for yourself with your heart-attack results," he says.

(He is referring to my conflicting results for heart-attack risk from the three websites. One rated me as high risk, one as low risk, and the other as medium risk. "You should not be getting contradictory results like that," says Feero.)

Universities and medical groups are also taking steps to move into the new age of genomics, with initiatives to improve education for doctors and a flurry of articles and letters in medical and research journals.

Several major medical centers are developing their own tests vetted by scientists and physicians.

Baylor College of Medicine in Houston, for instance, is developing a custom gene-testing array focused on about 10,000 genetic markers associated with diseases. This is different from off-the-shelf arrays used by retail testing services that do not cover many genetic markers associated with disease.

In New Jersey, meanwhile, the nonprofit Coriell Institute for Medical Research is developing a service that will test for a slate of validated genetic markers, and provide free—yes, free—information and analysis for common diseases. The institute plans to sign up 10,000 people in the next two years, and to eventually enlist 100,000 people.

The big medical-testing companies are also finding a market for offering traditional physician-ordered tests for genetic markers. Quest Diagnostics, for instance, earns $1 billion a year from molecular diagnostic testing, which includes dozens of DNA tests.

DNA Direct has another model; combining some aspects of traditional medical testing with an online service and offering products for sale over the internet. DNA Direct has a range of individual, doctor-approved tests that are ordered one at a time, usually when one's family history suggests a test is needed.

Over the next year or two, we are likely to see a miniature version of the dotcom shakeout occur in genetic testing. This is a moment when experimentation with business models will be as varied and edgy as the science itself, which also will continue to rapidly improve the quality of DNA testing and analysis.

But make no mistake: The long anticipated age of personalized genomics has arrived—perhaps in fits and starts, but it's here. And it will change not only the practice of medicine and how we take care of ourselves, but also may change how we view our health and who we are.

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