Scientists are working to develop tests that are simple, cost-effective, and accurate. Tests need to be validated in broader populations, establishing that cancer susceptibility is caused by the gene mutation itself, not by other genetic or environmental factors shared by high-risk families. By comparing the cancer-causing genes of more and more people, researchers will be able to zero in on which of a gene's many mutations are significant and thus arrive at reasonably accurate predictions of disease risk. Demand could quickly overwhelm the current extremely limited facilities and personnel available for DNA testing. Laboratories need to develop proficiency in these new techniques, and to assure accuracy and quality control.
Genetic counselors are also in short supply.
People contemplating gene testing need information and guidance in order to make informed choices and weather the psychological stresses. The demand created by widespread testing would readily swamp the nation's approximately 1,200 genetic counselors, and it is likely that the task of education and counseling will fall to primary care physicians and nurses. Few primary health care providers, however, have training in this area. Public health costs are significant. In addition to the charges for the tests themselves, there are the expenses of counseling and of followup clinical screening and frequent monitoring.