Gene-environment interactions was a hot topic during the first part of Stream A in the panel discussion on The Promised Land of Genomic Medicine: Where Can the Science Take Us?
The moderator, Göran Hansson, posed the question: How far are we from understanding these interactions?
Eric Lander raised a really interesting point that the general public perceive genetics as risk factors of disease. He disagreed with this impression saying “genetics is here to understand mechanism”. It seems that geneticists need to portray as Lander said that “genes and environment works inextricably together”.
Using lung cancer as an example, Lander said that we can understand the genes involved but we need to address the huge environmental factor: smoking. He added that we need to communicate science better to get people to stop smoking and understand this obvious environmental effect.
In some diseases, I thought it was brilliant that this panel of geneticists were willing to question the focus on genetic research. Joe Goldstein said “we have to deal with patients with diseases that have strong familial components”. He cited colon cancer as an example where a colonoscopy is much better than getting your genome sequenced.
If you look at cancers in a population, the hereditary impact varies between 3 and 10%. Using breast cancer as an example, Mary Claire King said that by working with families that are severely affected by the disease, they were able to isolate the genes involved: BRCA1 and the many others found since. She said Europe was better at testing for these mutations but the United States needed to improve. If these mutations are tested in women, these cancers can be prevented. I think this is true for many new technologies involving genetics – governments are slow to adopt them which to me seems short-sighted given the costs involved downstream for treatment.
This short-term focus was also raised by Bert Vogelstein who said that “we, as a society, are so focused on curing these advanced cancers that we don’t see other ways to tame the beast”.
This was such an fascinating discussion. Now that we know so much more about the genetic mechanisms, it seems that looking towards the impact of the environment is more possible. Göran Hansson summed this up saying “we are probably in for a new era of diagnostics”.
Maria Delaney tweets @mhdelaney.