From 2004 to 2024, the Health Resources and Services Administration (HRSA) funded the National Coordinating Center for the Regional Genetics Networks (NCC). NCC developed and maintained the Genetics Policy Hub.

 

With the conclusion of NCC funding, the Genetics Policy Hub (GPH) will no longer be updated or maintained. Information on GPH should be used for historical reference only.

Direct-to-Consumer Testing

Updated On Sep 19, 2024

This information is meant to be used for educational purposes to inform providers, patients, and genetic service delivery stakeholders about genetics policy topics. Sharing of information, resources, or policy statements is no way an endorsement of stated positions by NCC.

Introduction

    Direct-to-Consumer (DTC) genetic testing are tests that are ordered directly from the laboratory by the individual being tested, often without the input of a medical provider. These tests can be risk assessments (i.e., determines an individual’s risk of developing disease, but cannot determine if the individual has the disease), diagnostic, or carrier testing (i.e., tries to determine the risk of having a baby with a specific disease). The level of support the genetic testing laboratory offers in helping the patient understand their results vary widely.

    Many articles have been written about DTC genetic testing. A summary of the issues surrounding DTC genetic testing are discussed in ”Direct-to-consumer genetic testing: advantages and pitfalls,” which can be found in this article. The National Human Genome Research Institute (NHGRI) has also created a page of information that includes resources and a FAQ page for healthcare professionals. Some of the concerns raised in these, and other, writings are:

    • Because DTC tests are ordered by the patient without input of a provider, are patients getting enough information to understand the limitations of the testing and the implications of the results?
    • What obligations do DTC companies have? Do they need to provide pre-test counseling, follow-up care, or answer a patient’s questions?
    • When patients order DTC tests, whose responsibility is it to do any follow-up, such as answering questions?
      • If a patient has questions about a test that their health insurance wouldn’t have paid for, is that health insurance obligated to pay for a provider to answer questions?
      • If a DTC test shows that someone may be at risk of having a condition, but has no other symptoms, who should pay for confirmatory testing?
      • If a DTC test reveals previously unknown family relationships, does the DTC company have any obligation for counseling of the patient?

    Legislation and Regulation

    The federal agency that regulates DTC testing is the Food and Drug Administration (FDA). For more information including a list of DTC tests with marketing authorization and a section on frequently asked questions about DTC testing, please visit the FDA’s website.

    Are you interested in learning what your state’s government or the federal government are currently proposing for either legislation or regulation? Check out Legislative/Tracking system for up-to-date information and subscribe to our Twitter channel to get the latest updates in your pocket.

    Policy Positions

    Organizations working within the genetics community (national genetic organizations, advocacy organizations, etc.) have published positions on direct-to-consumer testing. Explore these position statements below.

     

    Position Statements by Organizations
    Direct to Consumer Genetic Testing
    Organization
    American Academy of Family Physicians (AAFP)
    Subject
    Direct-to-Consumer Testing
    Date
    July 1, 2019
    ACMG SF v3.1 list for reporting of secondary findings in clinical exome and genome sequencing: A policy statement of the American College of Medical Genetics and Genomics (ACMG)
    Organization
    American College of Medical Genetics and Genomics (ACMG)
    Subject
    Direct-to-Consumer Testing
    Date
    February 28, 2022
    Ancestry Testing Statement
    Organization
    American Society of Human Genetics (ASHG)
    Subject
    Ancestry Genetic Testing Direct-to-Consumer Testing
    Date
    November 13, 2008
    Direct-to-consumer genetic testing: a revised position statement of the American College of Medical Genetics and Genomics
    Organization
    American College of Medical Genetics and Genomics (ACMG)
    Subject
    Direct-to-Consumer Testing
    Date
    December 17, 2015
    Direct-to-Consumer Genetic/Genomic Testing (DTC-GT)
    Organization
    International Society of Nurses in Genetics (ISONG)
    Subject
    Direct-to-Consumer Testing
    Date
    September 1, 2022
    Advancing Evidence-Based Genetic Testing
    Organization
    American Society of Human Genetics (ASHG)
    Subject
    Genetic Testing Direct-to-Consumer Testing
    Date
    January 8, 2018
    At-Home Genetic Testing Position Statement
    Organization
    National Society of Genetic Counselors (NSGC)
    Subject
    Direct-to-Consumer Testing Genetic Privacy
    Date
    June 24, 2023

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