Direct-to-Consumer DNA Test: What to Expect?

March 14, 2023

DNA Test — Image by Southworks via Shutterstock

It seems quite incredible that anyone can buy a test that reads your genetic information and tells you all about your ancestry, medical predispositions, and physical condition, among other things. “Direct-to-consumer” or “at-home” DNA tests make it possible. Recently, these tests have become extremely popular and their market exploded. Let’s have a look at what companies can offer.

Direct-to-consumer DNA tests are genetic tests which tell a customer about their genealogy, medical predispositions, and physical conditions without the involvement of a health care specialist.
Direct-to-consumer DNA tests can be classified according to test analysis type, how genetic information is analyzed during test performance, and test result.
To receive accurate results, it is important to consider several factors about the company performing the test: their privacy and security statements, described test performance quality, and offered further support.
To avoid any misunderstanding of test results, the customer is still strongly advised to consult with a qualified health care specialist.

What are direct-to-consumer DNA tests?

Direct-to-consumer DNA tests are genetic tests that can be ordered and completed by anyone in the general public without the involvement of a health care specialist. These tests can be performed without leaving home when the customer emails in their sample (saliva, cheek swab, blood, etc.) and receives the results in an online report.

Test classification by analysis type

These tests analyze customer genetic information, in other words, a person's DNA structure and changes, to predict the probability of development of specific diseases, or to identify a person’s ancestry. There are three types of direct-to-consumer DNA tests:

Test type	Description
Autosomal DNA	Autosomal DNA is DNA found within the nucleus of the somatic cell — the cells in the body other than germ cells (sperm and egg cells). People receive half of their autosomal DNA from their father, and the other half from their mother. Autosomal DNA tests determine results from both maternal and paternal sides of the family. The most popular type of at-home DNA test. Example text.
Mitochondrial DNA (mtDNA)	Mitochondria are the organelles found in eukaryotic (organisms whose cells contain a nucleus) cells. All mitochondrial DNA are inherited from the mother. Mitochondrial DNA trace only genetic relationships on a maternal line. Both men and women can take mtDNA tests.
Y-chromosome (Y-DNA)	The Y chromosome is one of the two sex chromosomes in humans and is only present in males. The genetic information in the Y chromosome is passed from father to son virtually unchanged. Only males can take Y-chromosome tests. Only paternal-line genetic relationships can be identified.

Test classification by obtained results

In the very beginning, direct-to-consumer DNA tests were developed to estimate the probability of the onset of several common diseases. However, the companies that offer them quickly noticed that such tests can also answer other questions related to genetics, e.g., origin. As a result, direct-to-consumer DNA tests available on the market today can answer these questions:

Disease risk. The results of these tests predict your genetic risk of developing certain inherited diseases (e.g., Alzheimer disease, Parkinson disease, some types of cancer, etc.) that can be caused by multiple variants in several genes.
Genealogy. The results of these tests find and identify clues about the origin of the person's ancestors (their ethnicity).
Kinship. The results of these tests tell if a genetic relationship exists between two or more people (e.g., father/mother–child, siblings, aunt/uncle–niece/nephew, etc.).
Health. Some tests provide information about a person's organism response to various drugs. Others can even estimate a person's genetic predisposition to obesity.
Lifestyle. The results of these tests tell the customer information about the most suitable lifestyle factors for them, e.g., type of nutrition, fitness, skincare products, etc. Usually, the companies which sell this kind of testing also offer programs or products customized according to the obtained results.

How to choose a direct-to-consumer DNA test?

If the customer wishes to receive accurately, clearly explained results, it is important to choose the most suitable test company. It is important to notice that direct-to-consumer DNA tests for nonmedical or low-risk medical purposes are not reviewed by the Food and Drug Administration (FDA) before they are sold on the market. Therefore, it becomes very critical for the customer to make the right choice. There are several factors that should be considered before choosing a test:

Expected results. Not all DNA tests screen the same genes for the same factor evaluation. It is important to choose a test which evaluates the widest gene range.
Privacy and security. It is important to review a company’s privacy policy, because some may sell personal data to third parties or may allow non-authorized personnel to access customers' information. Others do not guarantee sufficient protection.
Test performance quality. It is highly recommended to choose companies that process tests in laboratories that follow state and federal regulation requirements.
Further support. It is much easier for the customer to understand the results if a company provides extra support services — for example, online consultation with a doctor to discuss test results.

Companies providing direct-to-consumer DNA testing services

Below you may find the list and short description of the most popular companies:

23andMe. Founded in 2006. It was one of the first companies which started to offer genetic testing and result-in interpretation services to customers. It performs tests related to health, ancestry, and traits, thus the wide spectrum of direct-to-consumer DNA tests can be found and ordered on the company's website. 23andMe is the first company that got FDA approval for a home DNA test evaluating the genetic risk for 10 diseases and conditions, including Parkinson's disease, celiac disease, and late-onset Alzheimer's disease.
AncestryDNA. Founded in 1990 under the name ”Ancestry.com”. As the company’s name suggests, it is strong in customer ethnicity estimation. AncestryDNA also offers tests to screen customers' genetic risk for heart disease, some cancers, and blood disorders. However, the obtained results are not diagnostic, because the company’s tests aren't approved by FDA.
FamilyTreeDNA. Founded in 2000, offers a wide range of tests in the field of genetic genealogy (estimates relationships between individuals, determines ancestries, etc.). In addition, all three types of DNA analysis tests (autosomal DNA, Y-DNA, and mtDNA) are available in this company. Finally, it is the sole company that does not send the customer's samples to third-party laboratories, but analysis all the tests in its own testing facility.
MyHeritage. Founded in 2003, started as a genealogy determination platform and keeps this direction till now. Since 2019, the company also presented a health test similar to the one offered by 23andMe. However, the test still does not have FDA approval.
LivingDNA. Founded in 2016. The company offers DNA tests that determine a person's ancestry as well as so-called “well-being” tests, which tell the customer about its organism compatibility with food supplements, diets, etc.

The supply of direct-to-consumer DNA tests in the market is huge and still growing. Furthermore, not all companies test the same DNA parts when evaluating disease/condition risk or determining ancestry. Therefore, the results among them may differ. Due to this reason, customer needs to make a responsible choice before purchasing a test. Finally, to avoid any misunderstanding of the results, customers are strongly advised to consult with a qualified healthcare specialist.