Genetic tests for all – the new approach to preventive medicine

Genetic tests that can detect a raised risk of breast, ovarian and prostate cancer are being offered for the first time to people without family histories of the diseases, The Times has learnt.

The programme, run by University College London (UCL), paves the way for a new approach to preventive medicine involving widespread screening. It will also prompt greater demand for screening of embryos by parents who carry a defective gene and want to avoid passing it to their children.

News of the programme came as Paul Serhal, medical director at University College Hospital’s Assisted Conception Unit, announced the birth of one of the world’s first babies selected to be free of a genetic risk of breast cancer. The girl was born after embryos were screened to exclude the faulty BRCA1 gene. All the father’s female relatives had developed breast cancer caused by BRCA1. The gene gives a woman an 80 per cent chance of developing breast cancer in her lifetime and raises the risk of ovarian and prostate cancer.

The two developments show the speed with which advances in genetic screening are having an impact on patient care. Genetic tests can now identify people with heightened risks of chronic conditions such as heart disease and diabetes and even high cholesterol.

Embryo screening, which is licensed for certain serious conditions, such as Huntington’s disease and cystic fibrosis, continues to attract controversy, with claims that it is paving the way for the creation of “designer babies”. However, doctors’ leaders argue that a technique that can prevent a child from developing a life-threatening illness should not be restricted.

The UCL screening programme is focusing on the London community of Ashkenazi Jews, who have a high risk of inheriting BRCA1 and BRCA2. The NHS offers BRCA testing, but only for women whose relatives have had cancer because of the mutations. Up to 50 per cent of people with the faulty genes do not have a family history of the diseases, largely because the gene can be carried by men.

January 10, 2009
Mark Henderson and Sam Lister

Source: The Times

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