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Viewpoint: Aetna’s Mitesh Patel: Is genetic testing the future of healthcare?

Innovation in DNA analysis is creating new options for early intervention
Mitesh Patel

Earlier this week, researchers from a New Zealand university announced that the DNA they had collected from water samples could uncover the truth behind the fabled Loch Ness Monster. It just goes to show how far and wide our scientific understanding of deoxyribonucleic acid, otherwise known as DNA, now reaches.

This tiny double-helix structure has had an enormous impact across a wide range of fields, with advances meaning that DNA testing is now routinely used in criminal investigations, paternity cases, agriculture, archaeology, forensics and, of course, healthcare.

Medically speaking, innovation in DNA analysis has opened up a wealth of different options for early intervention, from newborn screening to diagnostic assessment to testing specifically for particular conditions, such as cystic fibrosis.

However, over and above this, perhaps one of the most exciting things DNA testing offers healthcare is the opportunity to effect positive behavioural change on a much larger scale, by tackling issues one person at a time. In order to understand how what sounds like an oxymoron can work – and why this is such an exciting prospect – we need to start by looking at the bigger picture.

Bearing the strain

Across the world, we’re seeing an increase in lifestyle-related diseases such as cardiovascular issues and cancer. The World Health Organisation states that these types of non-communicable diseases (NCDs) represent 71% of all annual deaths. This puts a huge strain on local health care systems. In the US, for example, health care spending has reached US$3.5trn and is estimated to increase 5.5% every year. It just isn’t sustainable.

To combat this, there is a pressing need to move away from reactive, demand-driven healthcare systems to preventative, need-driven ones, treating people not as patients, but as active consumers.

However, one of the industry’s key challenges is to motivate people to modify their behaviour, and ensure new behaviours stick.

As with any complex situation, there isn’t a single easy answer. To make effective inroads, strategies to improve will need to be multi-faceted, including education programmes and ensuring social support for example. But they will also need to be personalised – and that’s where understanding your own DNA in regards to health and lifestyle can help.

A positive influence

While we know that there are certain components that will have a positive influence on everyone’s health and wellbeing – a balanced diet, a good night’s sleep or regular exercise – what we’re not always aware of is exactly how these things personally affect us. You might be able to drink caffeine directly before bed without any ill-effect, for example, whereas it could keep me up all night.

Just as precision medicine (focusing on the approaches that are most effective for individuals based on genetic, environmental and lifestyle factors) brings tangible benefits, so does understanding your own body’s responses to certain foods or cardio exercise over weight-training. It can offer both insight and reassurance that you’re on the right path to wellness and tailoring your approach to health in a way that makes most sense to you. And if these insights can be accompanied by the option of a follow-up consultation with a nutrition or fitness expert, so much the better.

A growing market

The huge rise of popularity when it comes to genetic testing market is an ascent that shows no signs of slowing. According to Global Market Insights, the sector will be worth US$22bn by 2024, driven by the public’s appetite for knowledge. So it’s incumbent on medical insurers to keep on top of how developments might affect both the industry and their members’ quest for a healthy life.

Of course, the type of information a health and lifestyle DNA test can confer is only the tip of the iceberg – it’s what individuals do with it that counts. But there is evidence to suggest that the positive impact from finding out more about your genetics can be truly life-changing.

For example, one study in Finland tracked 7300 people over an 18 month period, after they had received their genetic risk information. It found that 88% of participants were inspired to take better care of their health and around a fifth of those who smoked managed to give up. This compares well with a control group of the general population, where only 4% gave up smoking.

It goes to show that knowledge can be truly empowering – whether it’s the truth about the Loch Ness Monster or staying engaged in your own health journey.

Mitesh Patel is medical director at Aetna International.