As genome sequences get cheaper, is more always better?

The time and cost of whole genome sequencing is tumbling, with Illumina and Life Technologies both announcing the launch of equipment making sequences possible in less than a day for under $1,000. What's not to like? As with everything in life, there are two sides to the story.

From the biomarker research perspective, cutting the cost of sequencing is an exciting prospect—more sequences available to researchers from more individuals, or even series of sequences from the same individual through health, disease and then treatment and recovery or relapse, provide more data for comparison. The bottleneck will be processing the quantities of new data.

Making genome sequencing cheaper could potentially open up personalized medicine to more people. However, there are ethical issues associated with this. Routine genetic sequencing could provide the information on a patient's genetic biomarkers leading to diagnosis or prognosis that they and their physicians need. But it could also detail potential risk factors. That raises the question of whether people should be told about their risk of Alzheimer's disease, heart disease, cancer and other ailments. And what if sequencing becomes routine when starting school, or even at birth?

Even though the cost is likely to be as low as $1,000, routine sequencing and analysis of the data will impose a financial burden on healthcare providers in countries with health systems that are already strapped for cash. In countries where people need health insurance, will all insurers pay? If not, this could create even more of a two-tier healthcare system than exists in many countries. — Suzanne Elvidge (email)

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