Genetic testing, also known as
DNA testing, allows the determination
of bloodlines and the genetic diagnosis of vulnerabilities to
inherited diseases. In agriculture, a form of genetic testing known as
progeny testing can be used to evaluate the quality of breeding stock.
In population ecology, genetic testing can be used to track genetic
strengths and vulnerabilities of species populations.
In humans, genetic testing can be used to determine a child's
parentage (genetic mother and father) or in general a person's
ancestry or biological relationship between people. In addition to
studying chromosomes to the level of individual genes, genetic testing
in a broader sense includes biochemical tests for the possible
presence of genetic diseases, or mutant forms of genes associated with
increased risk of developing genetic disorders.
Genetic testing identifies changes in chromosomes, genes, or
proteins. The variety of genetic tests has expanded throughout the
years. In the past, the main genetic tests searched for abnormal
chromosome numbers and mutations that lead to rare, inherited
disorders. Today, tests involve analyzing multiple genes to determine
the risk of developing specific diseases or disorders, with the more
common diseases consisting of heart disease and cancer. The results
of a genetic test can confirm or rule out a suspected genetic
condition or help determine a person's chance of developing or passing
on a genetic disorder. Several hundred genetic tests are currently in
use, and more are being developed.
Because genetic mutations can directly affect the structure of the
proteins they code for, testing for specific genetic diseases can also
be accomplished by looking at those proteins or their metabolites, or
looking at stained or fluorescent chromosomes under a microscope.
1.1 Specific diseases
2 Medical procedure
3 Risks and limitations
Direct-to-consumer genetic testing
5 Government regulation in the United States
6 In popular culture
7.1 Pediatric genetic testing
9 See also
Genetic testing is "the analysis of chromosomes (DNA), proteins, and
certain metabolites in order to detect heritable disease-related
genotypes, mutations, phenotypes, or karyotypes for clinical
purposes." It can provide information about a person's genes and
chromosomes throughout life. Available types of testing include:
DNA (cffDNA) testing is a non-invasive (for the fetus)
test. It is performed on a sample of venous blood from the mother, and
can provide information about the fetus early in pregnancy. As of
2015[update] it is the most sensitive and specific screening test for
Newborn screening is used just after birth to
identify genetic disorders that can be treated early in life. A blood
sample is collected with a heel prick from the newborn 24–48 hours
after birth and sent to the lab for analysis. In the United States,
newborn screening procedure varies state by state, but all states by
law test for at least 21 disorders. If abnormal results are obtained,
it does not necessarily mean the child has the disorder. Diagnostic
tests must follow the initial screening to confirm the disease. The
routine testing of infants for certain disorders is the most
widespread use of genetic testing—millions of babies are tested each
year in the United States. All states currently test infants for
phenylketonuria (a genetic disorder that causes mental illness if left
untreated) and congenital hypothyroidism (a disorder of the thyroid
gland). People with PKU do not have an enzyme needed to process the
amino acid phenylalanine, which is responsible for normal growth in
children and normal protein use throughout their lifetime. If there is
a buildup of too much phenylalanine, brain tissue can be damaged,
causing developmental delay.
Newborn screening can detect the presence
of PKU, allowing kids to get put on a special diet right away to avoid
the effects of the disorder.
Diagnostic testing is used to diagnose or rule out
a specific genetic or chromosomal condition. In many cases, genetic
testing is used to confirm a diagnosis when a particular condition is
suspected based on physical mutations and symptoms. Diagnostic testing
can be performed at any time during a person's life, but is not
available for all genes or all genetic conditions. The results of a
diagnostic test can influence a person's choices about health care and
the management of the disease. For example, people with a family
history of polycystic kidney disease (PKD) who experience pain or
tenderness in their abdomen, blood in their urine, frequent urination,
pain in the sides, a urinary tract infection or kidney stones may
decide to have their genes tested and the result could confirm the
diagnosis of PKD.
Carrier testing is used to identify people who carry
one copy of a gene mutation that, when present in two copies, causes a
genetic disorder. This type of testing is offered to individuals who
have a family history of a genetic disorder and to people in ethnic
groups with an increased risk of specific genetic conditions. If both
parents are tested, the test can provide information about a couple's
risk of having a child with a genetic condition like cystic fibrosis.
Preimplantation genetic diagnosis:
Genetic testing procedures that are
performed on human embryos prior to the implantation as part of an in
vitro fertilization procedure. Pre-implantation testing is used when
individuals try to conceive a child through in vitro fertilization.
Eggs from the woman and sperm from the man are removed and fertilized
outside the body to create multiple embryos. The embryos are
individually screened for abnormalities, and the ones without
abnormalities are implanted in the uterus.
Prenatal diagnosis: Used to detect changes in a fetus's genes or
chromosomes before birth. This type of testing is offered to couples
with an increased risk of having a baby with a genetic or chromosomal
disorder. In some cases, prenatal testing can lessen a couple's
uncertainty or help them decide whether to abort the pregnancy. It
cannot identify all possible inherited disorders and birth defects,
however. One method of performing a prenatal genetic test involves an
amniocentesis, which removes a sample of fluid from the mother’s
amniotic sac 15 to 20 or more weeks into pregnancy. The fluid is then
tested for chromosomal abnormalities such as
Down syndrome (Trisomy
21) and Trisomy 18, which can result in neonatal or fetal death. Test
results can be retrieved within 7–14 days after the test is done.
This method is 99.4% accurate at detecting and diagnosing fetal
chromosome abnormalities. Although there is a risk of miscarriage
associated with an amniocentesis, the miscarriage rate is only 1/400.
Another method of prenatal testing is Chorionic Villus Sampling (CVS).
Chorionic villi are projections from the placenta that carry the same
genetic makeup as the baby. During this method of prenatal testing, a
sample of chorionic villi is removed from the placenta to be tested.
This test is performed 10–13 weeks into pregnancy and results are
ready 7–14 days after the test was done. Another test using
blood taken from the fetal umbilical cord is percutaneous umbilical
cord blood sampling.
Predictive and presymptomatic testing: Predictive and presymptomatic
types of testing are used to detect gene mutations associated with
disorders that appear after birth, often later in life. These tests
can be helpful to people who have a family member with a genetic
disorder, but who have no features of the disorder themselves at the
time of testing.
Predictive testing can identify mutations that
increase a person's chances of developing disorders with a genetic
basis, such as certain types of cancer. For example, an individual
with a mutation in
BRCA1 has a 65% cumulative risk of breast
cancer. Hereditary breast cancer along with ovarian cancer
syndrome are caused by gene alterations in the genes
BRCA1 and BRCA2.
Major cancer types related to mutations in these genes are female
breast cancer, ovarian, prostate, pancreatic, and male breast
cancer. Li-Fraumeni syndrome is caused by a gene alteration on the
Cancer types associated with a mutation on this gene
include breast cancer, soft tissue sarcoma, osteosarcoma (bone
cancer), leukemia and brain tumors. In the Cowden syndrome there is a
mutation on the PTEN gene, causing potential breast, thyroid or
endometrial cancer. Presymptomatic testing can determine whether a
person will develop a genetic disorder, such as hemochromatosis (an
iron overload disorder), before any signs or symptoms appear. The
results of predictive and presymptomatic testing can provide
information about a person’s risk of developing a specific disorder,
help with making decisions about medical care and provide a better
Pharmacogenomics: type of genetic testing that determines the
influence of genetic variation on drug response. When a person has a
disease or health condition, pharmacogenomics can examine an
individual’s genetic makeup to determine what medicine and what
dosage would be the safest and most beneficial to the patient. In the
human population, there are approximately 11 million single nucleotide
polymorphisms (SNPs) in people’s genomes, making them the most
common variations in the human genome. SNPs reveal information about
an individual’s response to certain drugs. This type of genetic
testing can be used for cancer patients undergoing chemotherapy. A
sample of the cancer tissue can be sent in for genetic analysis by a
specialized lab. After analysis, information retrieved can identify
mutations in the tumor which can be used to determine the best
Non-diagnostic testing includes:
Forensic testing: Forensic testing uses
DNA sequences to identify an
individual for legal purposes. Unlike the tests described above,
forensic testing is not used to detect gene mutations associated with
disease. This type of testing can identify crime or catastrophe
victims, rule out or implicate a crime suspect, or establish
biological relationships between people (for example, paternity).
Paternity testing: This type of genetic test uses special
to identify the same or similar inheritance patterns between related
individuals. Based on the fact that we all inherit half of our DNA
from the father, and half from the mother,
DNA scientists test
individuals to find the match of
DNA sequences at some highly
differential markers to draw the conclusion of relatedness.
DNA test: To determine ancestry or ethnic heritage for
Research testing: Research testing includes finding unknown genes,
learning how genes work and advancing our understanding of genetic
conditions. The results of testing done as part of a research study
are usually not available to patients or their healthcare providers.
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See also: List of genetic disorders
Many diseases have a genetic component with tests already available.
This list is continuously changing with additions of new test
availabilities. This list below is just a few of the thousands of
African iron overload
Over-absorption of iron; accumulation of iron in vital organs (heart,
liver, pancreas); organ damage; heart disease; cancer; liver disease;
arthritis; diabetes; infertility; impotence
Alpha-1 antitrypsin deficiency
Obstructive lung disease in adults; liver cirrhosis during childhood;
when a newborn or infant has jaundice that lasts for an extended
period of time (more than a week or two), an enlarged spleen, ascites
(fluid accumulation in the abdominal cavity), pruritus (itching), and
other signs of liver injury; persons under 40 years of age that
develops wheezing, a chronic cough or bronchitis, is short of breath
after exertion and/or shows other signs of emphysema (especially when
the patient is not a smoker, has not been exposed to known lung
irritants, and when the lung damage appears to be located low in the
lungs); when you have a close relative with alpha-1 antitrypsin
deficiency; when a patient has a decreased level of A1AT.
Elevation of both serum cholesterol and triglycerides; accelerated
atherosclerosis, coronary heart disease; cutaneous xanthomas;
peripheral vascular disease; diabetes mellitus, obesity or
Becker/Duchenne muscular dystrophy
Muscle weakness (rapidly progressive); frequent falls; difficulty with
motor skills (running, hopping, jumping); progressive difficulty
walking (ability to walk may be lost by age 12); fatigue; intellectual
retardation (possible); skeletal deformities; chest and back
(scoliosis); muscle deformities (contractures of heels, legs;
pseudohypertrophy of calf muscles)
Reduced synthesis of the hemoglobin-beta chain; microcytic hypochromic
Venous thrombosis; certain arterial thrombotic conditions; patients
with deep vein thrombosis, pulmonary embolism, cerebral vein
thrombosis, and premature ischemic stroke and also of women with
premature myocardial infarction; family history of early onset stroke,
deep vein thrombosis, thromboembolism, pregnancy associated with
thrombosis/embolism, hyperhomocysteinemia, and multiple miscarriage.
Individuals with the mutation are at increased risk of thrombosis in
the setting of oral contraceptive use, trauma, and surgery.
Factor V Leiden
Venous thrombosis; pulmonary embolism; transient ischemic attack or
premature stroke; peripheral vascular disease, particularly lower
extremity; occlusive disease; cerebral vein thrombosis; multiple
spontaneous abortions; intrauterine fetal demise
Venous thrombosis; increased plasma homocysteine levels
PAI-1 gene mutation
Independent risk factor for coronary artery disease, ischemic stroke,
venous thrombosis (including osteonecrosis)
Breast, ovarian and prostate cancer
Uncontrolled division of cancer cells
Inflammation confined to the colon; abdominal pain and bloody
diarrhea; anal fistulae and peri-rectal abscesses can also occur
Large amount of abnormally thick mucus in the lungs and intestines;
leads to congestioni, pneumonia, diarrhea and poor growth
Congenital loss of hearing; -prelingual, non-syndromic deafness
Tendon xanthomas; elevated LDL cholesterol; premature heart disease
Predisposition of acute myeloid leukemia; skeletal abnormalities;
radial hypoplasia and vertebral defect and other physical
abnormalities, bone marrow failure (pancytopenia), endocrine
dysfunction, early onset osteopenia/osteoporosis and lipid
abnormalities, spontaneous chromosomal breakage exacerbated by
DNA cross-linking agents.
Mental retardation or learning disabilities of unknown etiology;
autism or autistic-like characteristics; women with premature
menopause. Subtle dysmorphism, log face with prominent mandible and
large ears, macroorchidism in postpubertal males, behavioral
abnormalities, due to lack of FMR1 in areas such as the cerebral
cortex, amygdala, hippocampus and cerebellum
Characterized by slowly progressive ataxia; typically associated with
depressed tendon reflexes, dysarthria, Babinski responses, and loss of
position and vibration senses
Over-absorption of iron; accumulation of iron in vital organs (heart,
liver, pancreas); organ damage; heart disease; cancer; liver disease;
arthritis; diabetes; infertility; impotence
Absence of ganglia in the gut
Progressive disorder of motor, cognitive, and psychiatric
Hypolactasia; persistent diarrhea; abdominal cramps; bloating; nausea;
Multiple endocrine neoplasia
MEN2A (which affects 60% to 90% of MEN2 families):Medullary thyroid
carcinoma; Pheochromocytoma (tumor of the adrenal glands); Parathyroid
adenomas (benign [noncancerous] tumors) or hyperplasia (increased
size) of the parathyroid gland; MEN2B (which affects 5% of MEN2
families): Medullary thyroid carcinoma; Pheochromocytoma; Mucosal
neuromas (benign tumors of nerve tissue on the tongue and lips);
Digestive problems; Muscle, joint, and spinal problems; Typical facial
features; Familial medullary thyroid carcinoma (FMTC) (which affects
5% to 35% of MEN2 families):Medullary thyroid carcinoma only
Myotonic muscular dystrophy
Affects skeletal and smooth muscle as well as the eye, heart,
endocrine system, and central nervous system; clinical findings, which
span a continuum from mild to severe, have been categorized into three
somewhat overlapping phenotypes: mild, classic, and congenital.
Pseudocholinesterase (also called butyrylcholinesterase or "BCHE")
hydrolyzes a number of choline-based compounds including cocaine,
heroin, procaine, and succinylcholine, mivacurium, and other
fast-acting muscle relaxants. Mutations in the BCHE gene lead to
deficiency in the amount or function of the protein, which in turn
results in a delay in the metabolism of these compounds, which
prolongs their effects.
Succinylcholine is commonly used as an
anaesthetic in surgical procedures, and a person with BCHE mutations
may suffer prolonged paraylasis. Between 1 in 3200 and 1 in 5000
people carry BCHE mutations; they are most prevalent in Persian Jews
and Alaska Natives. As of 2013 there are 9 genetic tests
Sickle cell anaemia
Variable degrees of hemolysis and intermittent episodes of vascular
occlusion resulting in tissue ischemia and acute and chronic organ
dysfunction; complications include anemia, jaundice, predisposition to
aplastic crisis, sepsis, cholelithiasis, and delayed growth. Diagnosis
suspected in infants or young children with painful swelling of the
hands and feet, pallor, jaundice, pneumococcal sepsis or meningitis,
severe anemia with splenic enlargement, or acute chest syndrome.
Lipids accumulate in the brain; neurological dysfunction; progressive
weakness and loss of motor skills; decreased social interaction,
seizures, blindness, and total debilitation
Cutaneous photosensitivity; acute neurovisceral crises
Genetic testing is often done as part of a genetic consultation and as
of mid-2008 there were more than 1,200 clinically applicable genetic
tests available. Once a person decides to proceed with genetic
testing, a medical geneticist, genetic counselor, primary care doctor,
or specialist can order the test after obtaining informed consent.
Genetic tests are performed on a sample of blood, hair, skin, amniotic
fluid (the fluid that surrounds a fetus during pregnancy), or other
tissue. For example, a medical procedure called a buccal smear uses a
small brush or cotton swab to collect a sample of cells from the
inside surface of the cheek. Alternatively, a small amount of saline
mouthwash may be swished in the mouth to collect the cells. The sample
is sent to a laboratory where technicians look for specific changes in
chromosomes, DNA, or proteins, depending on the suspected disorders,
DNA sequencing. The laboratory reports the test results in
writing to a person's doctor or genetic counselor.
Routine newborn screening tests are done on a small blood sample
obtained by pricking the baby's heel with a lancet.
Risks and limitations
The physical risks associated with most genetic tests are very small,
particularly for those tests that require only a blood sample or
buccal smear (a procedure that samples cells from the inside surface
of the cheek). The procedures used for prenatal testing carry a small
but non-negligible risk of losing the pregnancy (miscarriage) because
they require a sample of amniotic fluid or tissue from around the
Many of the risks associated with genetic testing involve the
emotional, social, or financial consequences of the test results.
People may feel angry, depressed, anxious, or guilty about their
results. The potential negative impact of genetic testing has led to
an increasing recognition of a "right not to know". In some cases,
genetic testing creates tension within a family because the results
can reveal information about other family members in addition to the
person who is tested. The possibility of genetic discrimination in
employment or insurance is also a concern. Some individuals avoid
genetic testing out of fear it will affect their ability to purchase
insurance or find a job. Health insurers do not currently require
applicants for coverage to undergo genetic testing, and when insurers
encounter genetic information, it is subject to the same
confidentiality protections as any other sensitive health
information. In the United States, the use of genetic information
is governed by the
Genetic Information Nondiscrimination Act
Genetic Information Nondiscrimination Act (GINA)
(see discussion below in the section on government regulation).
Genetic testing can provide only limited information about an
inherited condition. The test often can't determine if a person will
show symptoms of a disorder, how severe the symptoms will be, or
whether the disorder will progress over time. Another major limitation
is the lack of treatment strategies for many genetic disorders once
they are diagnosed.
Another limitation to genetic testing for a hereditary linked cancer,
is the variants of unknown clinical significance. Because the human
genome has over 22,000 genes, there are 3.5 million variants in the
average person's genome. These variants of unknown clinical
significance means there is a change in the
DNA sequence, however the
increase for cancer is unclear because it is unknown if the change
affects the gene's function. 
A genetics professional can explain in detail the benefits, risks, and
limitations of a particular test. It is important that any person who
is considering genetic testing understand and weigh these factors
before making a decision.
Other risks include accidental findings—a discovery of some possible
problem found while looking for something else. In 2013 the
American College of Medical
Genomics (ACMG) that certain
genes always be included any time a genomic sequencing was done, and
that labs should report the results.
Direct-to-consumer genetic testing
Direct-to-consumer (DTC) genetic testing is a type of genetic test
that is accessible directly to the consumer without having to go
through a health care professional. Usually, to obtain a genetic test,
health care professionals (such as doctors) acquire their patient's
permission and then order the desired test. DTC genetic tests,
however, allow consumers to bypass this process and order
There is a variety of DTC tests, ranging from tests for breast cancer
alleles to mutations linked to cystic fibrosis. Benefits of DTC
testing are the accessibility of tests to consumers, promotion of
proactive healthcare, and the privacy of genetic information. Possible
additional risks of DTC testing are the lack of governmental
regulation, the potential misinterpretation of genetic information,
issues related to testing minors, privacy of data, and downstream
expenses for the public health care system.
DTC genetic testing has been controversial due to outspoken opposition
within the medical community. Critics of DTC testing argue against the
risks involved, the unregulated advertising and marketing claims, and
the overall lack of governmental oversight.
DTC testing involves many of the same risks associated with any
genetic test. One of the more obvious and dangerous of these is the
possibility of misreading of test results. Without professional
guidance, consumers can potentially misinterpret genetic information,
causing them to be deluded about their personal health.
Some advertising for DTC genetic testing has been criticized as
conveying an exaggerated and inaccurate message about the connection
between genetic information and disease risk, utilizing emotions as a
selling factor. An advertisement for a BRCA-predictive genetic test
for breast cancer stated: “There is no stronger antidote for fear
Ancestry.com, a company providing DTC
DNA tests for genealogy
purposes, has reportedly allowed the warrantless search of their
database by police investigating a murder. The warrantless search
led to a search warrant to force the gathering of a
DNA sample from a
New Orleans filmmaker; however he turned out not to be a match for the
Government regulation in the United States
The examples and perspective in this article deal primarily with the
United States and do not represent a worldwide view of the subject.
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Currently, the U.S. has no strong federal regulation moderating the
DTC market. Though there are several hundred tests available, only a
handful are approved by the
Food and Drug Administration
Food and Drug Administration (FDA); these
are sold as at-home test kits, and are therefore considered "medical
devices" over which the FDA may assert jurisdiction. Other types of
DTC tests require customers to mail in
DNA samples for testing; it is
difficult for the FDA to exercise jurisdiction over these types of
tests, because the actual testing is completed in the laboratories of
providers. As of 2007, the FDA had not yet officially substantiated
with scientific evidence the claimed accuracy of the majority of
direct-to-consumer genetic tests.
With regard to genetic testing and information in general, legislation
in the United States called the Genetic Information Nondiscrimination
Act prohibits group health plans and health insurers from denying
coverage to a healthy individual or charging that person higher
premiums based solely on a genetic predisposition to developing a
disease in the future. The legislation also bars employers from using
individuals’ genetic information when making hiring, firing, job
placement, or promotion decisions. The legislation, the first of
its kind in the U.S., was passed by the
United States Senate
United States Senate on
April 24, 2008, on a vote of 95-0, and was signed into law by
George W. Bush
George W. Bush on May 21, 2008. It went into effect
on November 21, 2009.
In June 2013 the US Supreme Court issued two rulings on human
genetics. The Court struck down patents on human genes, opening up
competition in the field of genetic testing. The Supreme Court
also ruled that police were allowed to collect
DNA from people
arrested for serious offenses.
In popular culture
Some possible future ethical problems of genetic testing were
considered in the science fiction film Gattaca, the novel Next, and
the science fiction anime series "Gundam Seed". Also, some films which
include the topic of genetic testing include The Island, Halloween:
The Curse of Michael Myers, and the Resident Evil series.
Pediatric genetic testing
American Academy of Pediatrics
American Academy of Pediatrics (AAP) and the American College of
Genetics (ACMG) have provided new guidelines for the ethical
issue of pediatrics genetic testing and screening of children in the
United States. Their guidelines state that performing
pediatric genetic testing should be in the best interest of the child.
In hypothetical situations for adults getting genetically tested
84-98% expressing interest in getting genetically tested for cancer
predisposition. Though only half who are at risk of would get
tested. AAP and ACMG recommend holding off on genetic testing for
late-onset conditions until adulthood. Unless diagnosing genetic
disorders during childhood and start early intervention can reduce
morbidity or mortality. They also state that with parents or guardians
permission testing for asymptomatic children who are at risk of
childhood onset conditions are ideal reasons for pediatrics genetic
testing. Testing for pharmacogenetics and newborn screening is found
to be acceptable by AAP and ACMG guidelines. Histocompatibility
testing guideline states that it’s permissible for children of all
ages to have tissue compatibility testing for immediate family members
but only after the psychosocial, emotional and physical implications
has been explored. With a donor advocate or similar mechanism should
be in place to protect the minors from coercion and to safeguard the
interest of said minor. Both AAP and ACMG discourage the use of
direct-to-consumer and home kit genetic because of the accuracy,
interpretation and oversight of test content. Guidelines also state
that if parents or guardians should be encouraged to inform their
child of the results from the genetic test if the minor is of
appropriate age. If minor is of mature appropriate age and request
results, the request should be honored. Though for ethical and legal
reasons health care providers should be cautions in providing minors
with predictive genetic testing without the involvement of parents or
guardians. Within the guidelines AAP and ACMG state that health care
provider have an obligation to inform parents or guardians on the
implication of test results. To encourage patients and families to
share information and even offer help in explain results to extend
family or refer them to genetic counseling. AAP and ACMG state any
type of predictive genetic testing for all types is best offer with
genetic counseling being offer by Clinical genetics, genetic
counselors or health care providers.
DNA testing to determine if people are eligible for legal
privileges given to specific ethnic groups. The policy where "many
Jews from the Former Soviet Union (‘FSU’) are asked to provide DNA
confirmation of their Jewish heritage in the form of paternity tests
in order to immigrate as Jews and become citizens under Israel's Law
of Return" has generated controversy.
The cost of genetic testing can range from under $100 to more than
$2,000. This depends on the complexity of the test. The cost will
increase if more than one test is necessary or if multiple family
members are getting tested to obtain additional results. Costs can
vary by state and some states cover part of the total cost.
From the date that a sample is taken, results may take weeks to
months, depending upon the complexity and extent of the tests being
performed. Results for prenatal testing are usually available more
quickly because time is an important consideration in making decisions
about a pregnancy. Prior to the testing, the doctor or genetic
counselor who is requesting a particular test can provide specific
information about the cost and time frame associated with that
Molecular Anthropology portal
Whole Exome Sequencing
List of genetic disorders
List of genetic genealogy topics
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This article incorporates public domain material from the
United States Department of Health and Human Services
United States Department of Health and Human Services document "What
are the risks and limitations of genetic testing?". This article
incorporates public domain material from the United States
Department of Health and Human Services document "What is the cost of
genetic testing, and how long does it take to get the results?".
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