'Give Genetic Test Secrets To Insurers'

The results of genetic tests should be passed on to insurance companies to allow them to assess the health risks of potential customers, a professor of bioethics says today.

Prof Soren Holm, from Cardiff University Law School, says that genetic information is no more "sensitive or private" than other information about a person's health, including cholesterol levels and body mass index, which insurers can use to help them to set premiums. His recommendation was immediately rejected by health charities. They said greater openness could lead to "a genetic underclass", with people identified at risk of disease facing higher insurance premiums.

Yesterday scientists announced they had found 10 new genes linked to seven of the most common diseases, including heart disease, bipolar disorder and rheumatoid arthritis. Several European countries have introduced laws banning insurers from using predictive genetic test results to decide premiums. In 2005, a voluntary moratorium on the use of genetic testing results by insurance companies in Britain, originally introduced in 2001, was extended to 2011.

Under this agreement insurers can ask potential customers only about genetic tests for conditions that have been approved by the Genetics and Insurance Committee (GAIC), the body that advises the Government on the issue, and then only for life policies worth more than £500,000.

Huntington's disease, a degenerative brain condition, remains the only predictive test that has been approved by GAIC for disclosure to insurers.

Prof Holm, writing in the British Medical Journal today, says that "there is no good reason for not disclosing" genetic information. "If we accept that life or health insurers can legitimately seek and obtain other kinds of health information that predicts insurance risk, then we should also accept that they can seek genetic information that is predictive in the same way. There is no reason for treating genetic information differently," he says.

He adds: "Discrimination is already possible because an insurer can look at my BMI and conclude that I am at risk of contracting heart disease without taking into account that I was a person who did lots of exercise."

Prof Holm recognised that greater openness could discourage people from taking genetic tests amid fears that their premiums would rise if they tested positive, but he said that in those cases companies should be challenged about their decisions. However, Prof Richard Ashcroft, a biomedical ethicist at the University of London, argued in the same journal that a ban on insurers using genetic tests was needed to protect people from "irrational discrimination".

John French, of the Association of British Insurers, said: "We have no plans to submit any more applications to use predictive genetic tests for insurance purposes.

"Genetic technology is developing rapidly, but there is no certainty about the accuracy of particular genetic tests for diseases apart from Huntington's disease."

""Genetic technology is developing rapidly, but there is no certainty about the accuracy of particular genetic tests for diseases apart from Huntington's disease." "

Not so fast. Read this:

Biggest ever haul of genes linked to diseases

12:19 07 June 2007
NewScientist.com news service
New Scientist and Reuters

The largest ever study of genes and disease has found 10 new genes linked to seven of the most common conditions.

It represents the biggest single haul of disease-associated genes so far, and may lead better understanding of the diseases and new treatments.

"We are just scratching the surface," says Peter Donnelly at the University of Oxford, who led the Wellcome Trust Case Control Consortium behind the project. "Over the next couple of years, as these sorts of studies are extended, our understanding of the genetics of common diseases will change enormously."

Donnelly and colleagues from 50 research groups examined 500,000 genetic markers from 17,000 British individuals, comparing the genomes of diseased and healthy volunteers. In total, the investigation analysed 10 billion pieces of genetic information over a two-year period.

Linked diseases

Their findings include the discovery of four new chromosome regions containing genes that can predispose people to type 1 diabetes, and three new genes for Crohn's disease, the most common form of inflammatory bowel disease.

Excitingly, the team found a single gene that was associated with both Crohn's diseases and type 1 diabetes, suggesting the two auto-immune disorders are linked and share a biological pathway.

In the case of Crohn's disease, Donnelly's team uncovered the importance of a process known as autophagy, or "self eating", which cells use to clear unwanted material, such as bacteria. This could be key to explaining the role gut bacteria play in the condition.

They also found genetic links to coronary artery disease and hypertension, rheumatoid arthritis, bipolar disorder and type 2 diabetes.

New options

Significantly, many of the genes found were in areas of the genome not previously thought to have been related to the conditions, opening up completely new options for treatment.

The overall increase in risk of disease conferred by the various genetic risk factors was between 1.2 and 1.5 times, suggesting routine testing of patients is not worthwhile, the researchers say.

But Mark Walport, director of the Wellcome Trust, said there was a clear need for more research in even bigger projects, such as the UK Biobank scheme, which aims to test the DNA of half a million volunteers.

Journal reference: Nature (vol 447, p 661)

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