The cuts begin here

analysed for different diseases and sensitivity to medication. The results, which revealed risks of heart disease, diabetes and prostate cancer, could pave the way to similar tests for the general public.” The Daily Mirror on the same day was equally succinct, but at the same time both more and less informative: “A scientist has become the first person in the world to have his DNA screened. In a study published in The Lancet Prof Stephen Quake, a bioengineer at Stanford University, California, was examined for 55 conditions, ranging from type 2 diabetes to schizophrenia. But in another article heart scientist Prof Nilesh Samani, of Leicester University, wrote of ethical issues — ‘who should have their genome sequenced, what counselling be provided and who should have access to an individual’s genetic information’”. At the other extreme, The Independent allocated an entire page to a report on the scientific work plus a background commentary by science editor Jeremy Laurance. An excellent graphic highlighted nine different conditions, the risk in each case faced by Quake and the average risk for men of his age in the general population. For example, his risks of developing obesity, heart disease, diabetes and depression were 63%, 58%, 55% and 25%, respectively, as compared with average figures of 25%, 50%, 27% and 10%. Both the news report and commentary referred to wider aspects of the development and wider application of genome analysis. Laurance explained how it can provide information to help individuals live with increased susceptibility to particular maladies (as Quake has done by beginning to take statins to prevent cardiovascular disease). The new technique will also help doctors to encourage patients predisposed to lung cancer to stop smoking, and those prone to obesity or diabetes to moderate their diets. In other cases, Laurance pointed out, the provision of genetic information could be positively harmful, the only outcome being that an affected individual would have to live under the shadow of a threatened disease. “Analysis of your genome could reveal you were carrying a gene for Huntingdon’s disease, a condition that kills people in their 20s and for which there is no treatment. Would there be benefit in that?” Dwarfed by a headline “The DNA death test”, the Daily Mail carried a similar chart (with most of the percentages different from those in The Independent, but with the same general relative risks). Medical correspondent Jenny Hope pointed out that we are rapidly approaching an era when everyone will be able to have their DNA scanned for evidence of disease propensities. She said that tests already available commercially at around £300 can read part of a person’s genome, and that others costing $2,000 (£1,300) give verdicts on the risks of 50 common diseases. “Cardiologist Euen Ashley, one of the Stanford scientists, said the falling cost of genome sequencing would soon put screening of the full code within reach of the general public.” The $1,000 (£657) genome was coming fast. The challenge was in knowing what to do with all that information. “Professor Henry Greely, from Stanford Law School, said patients, doctors and geneticists are about to be hit by a ‘tsunami’ of genetic data. ‘We predict that an average person might need information about roughly 100 genetic risks,’ he said. He warned that it would take at least five hours to counsel the average patient about their genetic risks of disease, in addition to many hours of analysis to assess the nature of the risks.” The Guardian did most to explain the science behind the announcement. “The scientists began by building a data-base of gene variants and their links to medical conditions,” science correspondent Ian Sample wrote. “Atul Butte, who worked on the study, said: ‘We read thousands of publications and made a list of every single spot in the genome where we know that, for example, the letter A raises the risk of a particular disease, or the letter T confers protection.’” Although news editors had dramatically different feelings about the importance of this story, those who did cover it were united in one thing. None of them invoked those ethicists and commentators who can be relied upon to voice dire warnings about most advances in biomedicine. Good.