Abstract
In the UK, genomic health data is being generated in three major contexts: the healthcare system (based on clinical indication), in large scale research programmes, and for purchasers of direct-to-consumer genetic tests. The recently delivered hybrid clinical/research programme, 100,000 Genomes Project set the scene for a new Genomic Medicine Service, through which the National Health Service aims to deliver consistent and equitable care informed by genomics, while providing data to inform academic and industry research and development. In parallel, a large scale research study, Our Future Health, has UK Government and Industry investment and aims to recruit 5 million volunteers to support research intended to improve early detection, risk stratification, and early intervention for chronic diseases. To explore how current models of genomic health data generation intersect, and to understand clinical, ethical, legal, policy and social issues arising from this intersection, we conducted a series of five multidisciplinary panel discussions attended by 28 invited stakeholders. Meetings were recorded and transcribed. We present a summary of issues identified: genomic test attributes; reasons for generating genomic health data; individuals’ motivation to seek genomic data; health service impacts; role of genetic counseling; equity; data uses and security; consent; governance and regulation. We conclude with some suggestions for policy consideration.
Highlights
Once the preserve of specialist clinical genetics departments, patient genomic health data are generated in mainstream medicine and from research participants
The commercial sector has recognised the appeal of marketing genetic health data agnostic to disease presentation [6], as well as the commercial value of genomic information [7, 8]
Technology We considered two types of genetic test technology: sequencing of one or more genes, including the ‘whole’ genome, and single nucleotide polymorphism (SNP) genotyping
Summary
Once the preserve of specialist clinical genetics departments, patient genomic health data are generated in mainstream medicine and from research participants. Primary care discussants (UK-based) reported that relatively few setting, including through 100kGP and other UK clinical research of their patients have so far presented with DTC-GT information; programmes such as Deciphering Developmental Disorders (DDD) those who do tend to be relatively young, educated and affluent.
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