Genetic Privacy and Data Protection: A Review of Chinese Direct-to-Consumer Genetic Test Services

Assessing Privacy Vulnerabilities in Genetic Data Sets: Scoping Review

BACKGROUND

Genetic data are widely considered inherently identifiable. However, genetic data sets come in many shapes and sizes, and the feasibility of privacy attacks depends on their specific content. Assessing the reidentification risk of genetic data is complex, yet there is a lack of guidelines or recommendations that support data processors in performing such an evaluation.

OBJECTIVE

This study aims to gain a comprehensive understanding of the privacy vulnerabilities of genetic data and create a summary that can guide data processors in assessing the privacy risk of genetic data sets.

METHODS

We conducted a 2-step search, in which we first identified 21 reviews published between 2017 and 2023 on the topic of genomic privacy and then analyzed all references cited in the reviews (n=1645) to identify 42 unique original research studies that demonstrate a privacy attack on genetic data. We then evaluated the type and components of genetic data exploited for these attacks as well as the effort and resources needed for their implementation and their probability of success.

RESULTS

From our literature review, we derived 9 nonmutually exclusive features of genetic data that are both inherent to any genetic data set and informative about privacy risk: biological modality, experimental assay, data format or level of processing, germline versus somatic variation content, content of single nucleotide polymorphisms, short tandem repeats, aggregated sample measures, structural variants, and rare single nucleotide variants.

CONCLUSIONS

On the basis of our literature review, the evaluation of these 9 features covers the great majority of privacy-critical aspects of genetic data and thus provides a foundation and guidance for assessing genetic data risk.

Demand for Direct-to-Consumer Genetic Testing Services in China and Its Implications for Precision Public Health - China, 2021

Introduction

In China, the direct-to-consumer genetic testing (DTC-GT) industry has been undergoing exponential growth during the past few years. This study intends to assess characteristics of DTC-GT users in China, estimate the price elasticity of demand, quantify monetary values of DTC-GT features, and discuss its implications to the development of precision public health.

Methods

A total of 629 participants with an average age of 28.8 years were collected from an online survey conducted in November 2021. A discrete choice experiment and a mixed logit modelling approach were used to elucidate consumer preferences to DTC-GT services and evaluate monetary values of certain features.

Results

DTC-GT users were found to have a higher level of income on average. The price elasticity of DTC-GT services was estimated to be −0.72 (95% CI −0.73 to −0.70). The willingness-to-pay for genetic testing features of physical traits, personality, and dietary recommendation were estimated to be 90, 107, and 220 CNY, respectively.

Discussion

The nature of big genomic data makes DTC-GT have the potential to aid in the advancement of precision public health through more precise disease prevention and control strategies. The study also notes the need for addressing potential drawbacks of DTC-GT and protecting genetic privacy.

Considerations for developing regulations for direct-to-consumer genetic testing: a scoping review using the 3-I framework

Direct-to-consumer (DTC) genetic testing exists largely outside of any regulatory schemes, and studies providing a comprehensive overview of the ethical, social, legal, and technological considerations for regulating these types of technologies are lacking. This paper uses the 3-I framework for policy analysis to analyze the ideas, interests, and institutions relevant to policy development for DTC genetic testing in North America and internationally. A scoping review was conducted. Citation databases were searched for papers addressing the ethical, social, legal, and technological implications of DTC genetic testing; stakeholder perspectives on and experiences with DTC genetic testing; or the effect of such testing on the healthcare system. Ninety-nine publications, organizational reports, governmental documents, or pieces of legislation were included. The ideas included are autonomy, informed decision making, privacy, and clinical validity and utility. The interests discussed are those of the public and healthcare providers. The institutions included are regulatory organizations such as the Food and Drug Administration in the United States, laws governing the implementation or delivery of genetic testing in general, and legislation created to protect against genetic discrimination. This analysis clarifies the ethical, social, legal, and technological issues of DTC genetic testing regulation. This information can be used by policy makers to develop or strengthen regulations for DTC genetic testing such as requiring an assessment of the clinical validity of tests before they become publicly available, controlling how tests are marketed, and stipulating requirements for healthcare provider involvement and informed consent.

Testing the talented child: Direct-to-consumer genetic talent tests in China

One controversial area of direct-to-consumer genetic testing in China is "genetic talent testing" for children. In this study, I show that while experts criticize genetic talent testing as unscientific, the persistence of genetic talent testing is not merely a product of parents' scientific illiteracy. Instead, genetic talent testing reflects parents' pragmatic use of technology in response to the parenting pressures in contemporary China. Parents see the results of genetic talent testing as offering an advantage for their children when combined with the intensive parenting strategy of precision education. Drawing on the sociology of testing, I argue how genetic talent testing in China is a product of broader concerns about population quality and can potentially reshape how parents imagine quality children through the theory of multiple intelligences. My study of this "off label" use of direct-to-consumer genetic testing also suggests that scientists need to broaden their imagination of potential misuses of their technologies.