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http://dailynews.yahoo.com/headlines/hl/story.html?s=v/nm/19980921/hl/hum14_1.html Genome map will change healthcare By E.J. Mundell SAN FRANCISCO, Sep 21, 1998 (Reuters) -- Medical advances linked to the mapping of the human genome -- the complete set of human genes -- will radically change the healthcare process, said Dr. Francis Collins, director of the National Human Genome Research Institute in Bethesda, Maryland. Collins spoke on Saturday to attendees at the 50th Scientific Assembly of the American Academy of Family Physicians, held in San Francisco. Genetic-based diagnostic tests and therapies are ``the next revolution in medicine,'' Collins told those gathered. He said that at this point in time, the federally sponsored Genome Project -- which aims to create a genetic ``map'' of the over 3 billion base pairs of DNA that make up the human genome -- is about ``half-way done,'' and should be complete by 2003, two years ahead of schedule. He noted that genome research to date has already yielded information about gene mutations that may be linked to specific diseases, and this may lead to screening tests for disorders such as cystic fibrosis, Alzheimer's disease, and various cancers. The recent genome-related discovery of a mutation linked to PARKINSON'S disease may be ``the biggest breakthrough in PaARKINSON'S'' in the past 30 years, he said. And he said a test for a mutation linked to the blood-iron disease hemochromatosis could become ``the first population-based genetic screen (available) in the next 5 years.'' Furthermore, the researcher believes that quick and easy genetic testing will, within the next decade, allow physicians to determine individual patient responses to various drugs. In the very near future, primary care physicians will routinely perform ``genetic tests before writing a prescription,'' Collins explained, ``because (they will) want to identify the poor responders.'' But he said screening tests will remain a ``hollow victory'' if no treatments are available to fight the disease in question. ``Do you really want to know that you're going to get Alzheimer's disease if there's nothing that can be done?'' Collins said in an interview with Reuters Health. Fortunately, however, the emerging science of ``pharmacogenomics'' should lead to DNA-based drug therapies able to prevent or treat a wide range of major illnesses. ``I believe that in the next 10 to 15 years that we will see really quite a change in therapeutics,'' Collins explained, from ''treating symptoms because we really don't understand the causes, to treatments which are based upon molecular understanding at the DNA level of what's wrong. I suspect they'll be much more effective, and they may even be able to be applied before the person ever gets sick.'' However, he warned that information on a individual patient's genome must remain within his or her private control. Collins told the meeting delegates that, as it stands today, gene-related loss of insurance ``is still a real possibility for some people.'' Speaking with Reuters Health, he said that ``we need, as an urgent matter, with federal legislation, to prevent that kind of scenario.'' Collins believes that both government and private industry must agree to ``take genetic predictive information off the table and just say 'We're not going to use that, we're not going to disclose that, that's private stuff.'' Copyright © 1998 Reuters Limited. -- Judith Richards <[log in to unmask]>