Genetic testing doesn’t drive up demand for more health services

Patients who have genetic testing done to detect their risk for multiple health conditions do not use more health services after testing than those who elect not to be checked, says a study published online May 17 in Genetics in Medicine.

Genetic tests increasingly are being marketed directly to patients, raising concerns among some physicians that they could cause a spike in patients requesting unnecessary screening and procedures, said Robert J. Reid, MD, PhD, lead study author and associate investigator with Group Health Research Institute in Seattle.

“Certainly, there is a lot of concern in the country that doing indiscriminate testing of individuals around their genetic susceptibility will alarm them and increase demand,” he said.

Researchers studied 1,599 insured patients between age 25 and 40 from the Henry Ford Health System in Detroit. Of those, 217 opted to get genetic tests. Patients who received the tests had more specialty physician visits before the checks than the untested group, but the study found no change in overall use of health care services among those who had the evaluations done and those who did not (link).

Researchers analyzed health care usage by participants for 12 months before and 12 months after genetic testing. Dr. Reid said the study took a conservative approach. It looked only at screening and procedures associated with four of eight conditions whose risk could be detected from the multiplex genetic susceptibility tests: type 2 diabetes mellitus, atherosclerotic coronary heart disease, colorectal cancer and lung cancer. Also, the tests were thoroughly explained to all study participants — something that doesn’t necessarily happen in everyday practice, Dr. Reid said.

“They certainly had a fair amount of material on which to base their decision, and they had follow-up to help them understand the results,” he said. “In most cases there is not a lot of counseling beforehand or a lot of explanation afterward.”

One surprising factor was how few patients opted to have the testing done, Dr. Reid said.

Blacks were significantly less likely than whites to choose testing, as were those with just a high school education or less. The age group studied could be a factor, as younger individuals may feel that such tests offer little value at that stage in their lives, he said.

More research needs to be done to determine how genetic tests impact behavior in larger groups of patients. Such tests may have a positive impact by motivating some patients to make healthier lifestyle choices.

“If someone is told they are at risk for heart disease or diabetes, it might prompt them to maintain a healthy body weight, try to lower their cholesterol or stop smoking,” Dr. Reid said. “I think that is the next stage — to see if it promotes positive health behavior.”