6. Since the lifetime risk of suffering a heart attack is 42% for men over the age of 40,24 it follows that this test can identify men who have, on average, a lifetime risk

of 67% of developing the most lethal disease of man.25 There is a dramatic difference between 42% and 67% lifetime risk. For example, individuals who are in the top quintile of the concentration of LDL cholesterol have only 1.3 times the population average risk of having a heart attack. Hence, a genetic test based on recently discovered sequence variants can identify people with added risk of heart attack that is twice that of those who are at the top of the cholesterol curve. In this context, it is important to keep Inhibitors,research,lifescience,medical in mind that the ability to assess risk of the heart attack by measuring

serum cholesterol has transformed cardiology into the most important field of preventive medicine. Given the rather high lifetime risk of heart attack in most industrialized Inhibitors,research,lifescience,medical populations, then it follows that even a small increase in predictive power for each individual can be valuable. Comparable estimates of average relative risk in the top 10% of people for other diseases included in the deCODEme genome scan are, for example, 5.2 for agerelated macular degeneration, 1.8 for type 2 diabetes and 3.0 for Crohn’s disease. There is good reason to believe Inhibitors,research,lifescience,medical that the predictive power of these genetic tests will increase in the near future. On the one hand, we expect additional associated sequence variants to be discovered. On the other hand, because risk estimates in current tests are typically only stratified by sex and ethnicity, advances can be made through the inclusion of other relevant Inhibitors,research,lifescience,medical background variables (for example, the waist-tohip

ratio and smoking history in the case of heart attack). In Inhibitors,research,lifescience,medical both cases, further epidemiological research is ATM inhibitor needed. However, contrary to the views of some commentators,11,13 these are not grounds for delay. The value of the discoveries so far, as reflected in the aforementioned example of heart attack, unequivocally warrants their use in genetic tests. The second main theme of concern raised by commentators relates to the capacity of consumers to understand and cope with Entospletinib manufacturer disease risk estimates from tests.8,9,12-14 Underlying these concerns is a somewhat paternalistic and patronizing view that information about disease risk is dangerous to the general public unless mediated in person by medical experts. Among the alleged dangers to the public are anxieties from overinterpreting risk estimates, which could lead to increased demands on health care providers and unnecessary medical procedures. We are not aware of any evidence that has been reported in support of this view, but there is at least some indirect evidence against it.26 However, even if such information were to provoke anxiety, the right of regulators or medical experts to prevent access to it is questionable.