Just add your saliva to the tube provided in the ancestry testing kit, and send it off in the mail. A few weeks later, you’ll get a secure email letting you know that your results are ready. For about $99, you’ll receive a detailed report of where your ancestors came from. Easy enough, right?
While ancestry testing might make for interesting conversation at the Thanksgiving dinner table, it doesn’t provide the same information as a family health history. It’s important for consumers to understand that ancestry testing is not a useful method for managing your health or predicting health outcomes of your future children.
Taking a detailed look at your family’s health history is still one of the best predictive health tools that we have, and it doesn’t cost a dime.
Ancestry Testing Versus Your Family Tree
Genetic ancestry testing is a DNA test that looks for patterns of genetic variation to determine where a person’s ancestors may have come from while exploring relationships between families. It does not, however, test for genes that are linked to common genetic disorders.
“Ancestry testing hasn’t been designed with health questions in mind, and as a result there are many gaps in information if you try to sort through and pull out health information from the results,” says Brianne Kirkpatrick, a board-certified genetic counselor and founder of Watershed DNA, a company that helps patients understand their ancestry/genealogy testing.
Although documenting family health history does not involve DNA testing, it is an important tool to help healthcare providers identify patterns of diseases or symptoms within a family.
First, answers to targeted questions about your family’s health history are collected and analyzed. A family tree is then constructed that goes as far back as grandparents and as far out as first cousins. This tree includes information about disease symptoms, age of onset, and current age or age of death.
After analyzing the family tree, providers can determine the patient’s risk of developing symptoms of certain diseases during their lifetime, or calculate the likelihood that their child will inherit a specific genetic disease. Providers can then offer DNA testing specific to the genetic disease suspected in a family to further refine the risk.
Record Relevant Medical History Information
The best way to obtain information about your family’s medical history is to start asking relatives, including parents, grandparents, aunts, uncles and cousins. A family gathering over Thanksgiving, for example, might be the most efficient way to collect this information.
It is important to ask questions that will capture rare, common and more complex disorders where genetics, environment and lifestyle factors all play a role. It’s also a good idea to ask family members to keep you updated on any changes over the next year, or devise a plan to touch base with them annually.
There are several tools provided by the Centers for Disease Control and Prevention and the National Society of Genetic Counselors that can provide a basic outline of what to ask your family members. The Surgeon General’s tool, called My Family Health Portrait, will help you record your family health history, where you can save the information, provide updates and print out a summary to share with family members and healthcare providers.
Combine Family Health History with DNA Testing
After you’ve collected your family’s medical information, you may have questions about your chances of developing a specific disease.
The most efficient and thorough method to obtain helpful medical advice is to review your family history with a healthcare professional who specializes in genetics, such as a genetic counselor. They will provide information about how DNA testing can be used within the context of your family history. You can then make an informed decision about whether or not you’d like to have testing performed.
It’s important to recognize that at-home genetic screening tests — such as ancestry DNA tests — aren’t going to pinpoint your health risks as well as a targeted DNA diagnostic test ordered by a healthcare provider.
“DNA and family history are complementary and most powerful when used together,” says Kirkpatrick. “Family medical history offers insights into disease risk that DNA testing alone does not, and vice versa. Neither is superior to the other,” she adds.
For some familial medical conditions, DNA tests may be limited or non-existent because our understanding of the genetic basis of certain diseases is still limited.
“Complex conditions like diabetes, mental illness, and cancer, for example, are caused by an interplay of many different genetic factors and environment…We can’t test for them, but knowing there is a family history can be important information for an individual and their care providers,” says Kirkpatrick.
Providers can use the information in your family history to develop a screening and surveillance plan for many of these complex genetic disease that lack a specific test.
What Comes After a DNA Test?
When DNA testing identifies a mutation that causes an increased risk to develop a disease, providers can discuss a new medical management plan, and refer individuals to other resources and support groups.
If the identified mutation increases the risk for future children, providers can discuss the option of preimplantation genetic testing (PGT). PGT has been performed successfully for several rare and common genetic disorders, where a specific genetic mutation has been identified in a family.
While an ancestry report may tell you that your great-grandparents may have actually come from France instead of Ireland, it doesn’t actually help you with planning your future family — it’s best to leave that to your doctor or genetic counselor.
Leslie is a board-certified clinical genetic counselor and former Program Manager for the preimplantation genetic testing (PGT) program of the ORM Genomics team and former Project Manager for SharingHealthyGenes.com. She completed her Bachelor’s degree at DePauw University and her Master’s degree in Genetic Counseling at the University of Texas Graduate School of Biomedical Sciences at Houston. Since graduating in 2000, she has worked as a clinical genetic counselor in several specialties including prenatal, pediatric and cancer genetics and has been very involved with the National Society of Genetic Counselors.