Many of us are compelled, at one point or another, to do a little self-diagnosis when something—an itch here or a pang there—comes up. (WebMD is possibly the bane of many a doc’s existence.) Fortunately or unfortunately, there are more than a few ways to feed our need for self-diagnosis in the health realm, among them at-home genetic testing kits and full-body CT scans.
Genetic testing kits from companies such as 23andme and Ancestry.com, which started out providing ancestral lineage reports, now claim to identify health risks associated with as many as 250 diseases, including breast cancer, heart disease and diabetes. While many people use these test kits as a fun diversion, the kits’ popularity has caused public health officials and doctors to point out their limitations for acquiring real health information, because of a lack of scientific validation for results related to more serious medical conditions.
“I recommend that patients follow their physician’s referral to a genetic clinic before proceeding with these types of test kits. They have the potential to be unreliable and could lead to misdiagnosis,” cautions Esther Henkle, a primary/family care doctor at Swedish’s Magnolia clinic.
These companies have also pinged the radars of regulators over the validity of their claims. In November 2013, 23andMe was asked by the FDA to discontinue sales of its DNA test kits after it repeatedly failed to prove the science behind its technology; the company has since suspended its health-related genetic reports.
DNA test kit results can have some preventive value, prompting patients to quit smoking or get screened for colon cancer—when used correctly, and under the supervision of a board-certified geneticist, says Fuki M. Hisama, M.D., genetic medicine clinic director for the University of Washington. She generally advises against these types of kits for nonrecreational use without the supervision of a doctor properly trained in the field of clinical genetics. “They simply haven’t proven accuracy, and there is a high probability for misinterpretation of results, which could lead to dangerous and costly medical testing for patients.” Patients interested in getting tested should look for a doctor specializing in genetics to explore the possibility further.
Another purportedly preventive technology, whole body scans, has faded in popularity in recent years—at one time there were independent centers built around this service—but is still available at many medical centers under physician guidance. One example are the electronic beam tomography (EBT) heart scans offered in Swedish’s customizable executive health screenings, as well as at other hospitals. As elective procedures, scans are sometimes touted as helpful because they screen bodily tissue for abnormalities in a non-invasive way, serving as a first step in prevention by detecting certain diseases, such as cancer and heart disease, in patients who are otherwise asymptomatic. However, there have been no studies proving the benefit of such scans, and these days, many doctors actively advise against them without a clear health indication.
Dr. Udo Schmiedl, a radiology specialist at Swedish, is one of those doctors. He informs patients that full body scans have the potential to be harmful both physically and psychologically. “Unless a patient has a specific risk factor for certain disease, and is working under the advisement of their physician, I feel that there is no need for a full body scan. Their findings pick up anything and everything in your body, which in most cases is benign. These findings can lead to costly, unnecessary medical procedures that are often psychologically damaging for patients. I do not recommend full body scans lightly.”
Scans can range in price from $1,200–$3,200 and are not covered by most insurance plans. Another factor to consider is exposure to radiation; the effective radiation dose of one CT scan can be the equivalent of what the average person receives from everyday background radiation over three to five years.
These tools are ultimately best wielded with the assistance of your primary care provider or a specialist who can help put that information in context—well before that list of signs and symptoms gleaned from test kits and full body scans gets out of hand. +