Wayne Hall, Rebecca Mathews and Katherine Morley discuss the limitations of genomic risk prediction for population-level preventive health care. Whilst genome-wide association studies and genomic sequencing have the potential to reveal susceptibilities to disease, they sound a note of caution about widescale implementation of such tests. In particular they point out that before genomic information is used in public health screening, it must first be shown that it predicts disease risk better than phenotypic information. They go on to point out that before genomic information can be used population wide, there must be cost-effective interventions available for those who would be found to be at risk, that such an approach would be more cost-effective than population-level interventions and finally that genetic risk information motivates the desired behaviour change. Currently there are no examples of genetic screening for disease risk that satisfy these criteria.
Funding: This work was funded by an NHMRC Australia Fellowship awarded to Wayne Hall. The funder played no role in the decision to submit the article or in its preparation.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Hall WD, Mathews R, Morley KI (2010) Being More Realistic about the Public Health Impact ofGenomic Medicine. PLoS Med 7(10): e1000347. doi:10.1371/journal.pmed.1000347
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University of Queensland
UQ Centre for Clinical Research
Royal Brisbane and Womens' Hospital
Herston, QLD 4029