| Genetic
Testing |
| Where
is Your Genetic Testing Done? |
 |
By
Amanda Ewart Toland,
PhD
Reviewed
by Miriam Komaromy,
MD
|
You
and your doctor or genetic counselor
have decided that genetic
testing is right for you. One of the next questions
you may ask is "Where is the actual test going to
be performed?" |
|
|
Genetic
Testing Isn't Like Getting A Cholesterol Test
|
Since
this is not a routine type of test that doctors order,
it is likely that your doctor's office does not have an
in-house laboratory or an affiliated laboratory that can
do genetic testing. Because of this, your doctor may not
know which laboratories offer a test that is right for
you and your family.
 |
| No
laboratory offers tests for all genetic disorders. |
|
To add to the complexity, there are hundreds of different
genetic disorders. Some are common, some are rare, and
to complicate matters further some involve several different
genes
— so no laboratory offers tests for all genetic disorders.
Even for a single disorder, for example hereditary
nonpolyposis colorectal cancer (HNPCC), there are
multiple laboratories that offer testing, but commercial
laboratories may only look for mutations
in the two most common of the six genes
that can cause this disorder. This means that they will
detect more than 90 percent of HNPCC cases, but not every
single case. |
|
 top
|
Finding A Testing
Facility
|
|
Your
doctor or genetic counselor should be able to recommend
testing facilities for your disorder. Once you have
a list of all the laboratories, there are still a number
of things that must be considered when choosing where
to send your sample for testing. For example:
|
- What
is the cost of the test?
- Is
this a commercial or research laboratory?
- Does
the laboratory test for the type of mutation your
family is likely to have?
- Does
the laboratory accept insurance payments for genetic
testing?
|
|
top
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Commerical
Versus Research Laboratories: Which Is Right for Me?
|
|
There
are many differences between commercial and research
laboratories. To help you and your doctor decide which
type might be better for you, it helps to know a little
bit about the differences between them.
|
Commercial
Laboratories
|
|
Commercial
laboratories are clinically approved for genetic tests
and generally undergo a series of tests to measure the
quality of their testing procedures. Because they offer
genetic tests on a fee-for-test basis, these labs have
a shorter turn-around time than research laboratories
and often will accept insurance as payment for the test.
One of the negatives of many commercial laboratories
is that they only offer testing for the most common
mutations or genes involved in a genetic disorder. If
your family has a very rare genetic disorder or has
a more common disorder with a rare cause, the test that
is right for your family may not be available commercially.
|
Research
Laboratories
|
| Commercial |
Research |
| Fee-for-service |
Often
free |
| Faster
results |
Slow
results |
| Take
insurance payments |
Don't
take insurance payments for some tests |
| Test
for common mutations |
Test
for common rare mutations |
| Services
are standardized |
Services
done with unknown quality control |
| Simple
process |
May
require additional information for research purposes |
On
the other hand, research laboratories usually offer
genetic testing for free. They will frequently offer
testing for rare or unusual genetic disorders that they
are interested in understanding more completely. They
may need additional information from you or your family
for their research studies. Because these laboratories
are offering the tests as part of a research program,
the results may not be available for months or even
years. In some instances, the laboratory may not even
contact your doctor if they do not find a mutation in
the gene they are testing. Many research laboratories
are not clinically approved for genetic testing, which
means no one is checking up on their testing process.
If you have a very rare disorder or do not have the
money or insurance to pay for genetic testing at a commercial
laboratory, testing through a research laboratory may
be right for you.
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