The Future of Medicine
Precision Medicine: What Does it Mean for Your Health?
Precision medicine, sometimes called personalized medicine, is an approach for protecting health and treating disease that takes into account a person’s genes, behaviors, and environment. Interventions are tailored to individuals or groups, rather than using a one-size-fits-all approach in which everyone receives the same care. But what does this mean and how can precision medicine protect your health?
You might have heard the term “precision medicine” and wondered how it relates to you. Precision medicine is about finding your unique disease risks and treatments that will work best for you. Here are some ways that a precision medicine approach can protect your health:
- Using Family Health History:
If you have a family health history(https://www.cdc.gov/genomics/famhistory/index.htm) of certain diseases, you are more likely to get that disease than someone without that family history. Knowing about your family health history can help you and your doctor take steps to prevent disease or find it early(https://www.cdc.gov/features/familyhealthhistory/index.html). In some cases, your doctor might recommend genetic counseling(https://www.cdc.gov/genomics/gtesting/genetic_counseling.htm)to help you decide whether to have genetic testing for a disease that runs in your family.
- Screening for Diseases Before You Get Sick:
Currently, all newborns in the United States are screened for certain medical conditions at birth as part of newborn screening(https://www.cdc.gov/newbornscreening/). Screening helps doctors find and treat these babies early, often before they get sick. Babies with certain newborn screening conditions need specific treatments, which can include following a special diet or taking medications.
- Tailoring Prevention:
Most common diseases like cancer and heart disease are due to a combination of lifestyle and genetic factors. However, some people have inherited conditions that make them more likely to get a disease, and these people could benefit from targeted interventions. Women with a BRCA1 or BRCA2 mutation(https://www.cdc.gov/genomics/disease/breast_ovarian_cancer/genes_hboc.htm) are more likely to get breast or ovarian cancer, and men with a BRCA1 or BRCA2 mutation(https://www.cdc.gov/genomics/disease/breast_ovarian_cancer/genes_hboc.htm) have an increased risk for some cancers as well. People with Lynch syndrome (https://www.cdc.gov/features/lynchsyndrome/index.html) are more likely to get colorectal (colon) cancer. People with familial hypercholesterolemia (https://www.cdc.gov/features/heartdisease/index.html) are more likely to develop heart disease at a younger age and to die from the disease. However, if you have one of these conditions which makes you more likely to get a disease, knowing about it can allow you to take steps to prevent the disease or find it early. These steps can include screening earlier or more often, taking medications, or surgery.
A precision medicine approach can also improve your treatment if you get sick and help public health better track disease:
- Tailoring Treatments:
Certain treatments only work on some people with a disease. For example, ivacaftor, a drug used to treat cystic fibrosis, only works on patients whose cystic fibrosis is due to certain genetic changes. Also, some people have versions of genes (gene variants) that make them more likely to suffer from rare side effects from certain medications. Checking for these gene variants before you take one of these medications can help you avoid medications that could be harmful for you.
- Finding and Tracking Infectious Diseases:
Looking at the DNA (https://www.cdc.gov/amd/basics/index.html) of germs can help track disease outbreaks when they occur. Doctors and public health officials can more easily find out which people’s illnesses are caused by the germ. Knowing exactly which germ is making their patient sick can help doctors determine the treatment that will work best. Testing for the germ can also identify affected products, such as specific foods, more easily. Research on precision medicine will look at how this approach can improve disease prevention and treatment.
- All of Us:
The All of Us research program, led by the National Institutes of Health, plans to enroll one million or more US participants, who will be followed for several years. All of Us participants will submit information about their medical history and lifestyle. Participants also may have certain physical measurements taken (for example, height, weight, and blood pressure) and provide urine or blood samples. All of Us will use this information to look at how genetic, behavioral, and environmental factors can affect health, including likelihood of getting certain diseases and effectiveness of prevention and treatments.
About the All of Us Research Program
Far too many diseases do not have a proven means of prevention, or effective treatment. We must gain better insights into the biological, environmental, and behavioral influences on these diseases to make a difference for the millions of people who suffer from them. Precision medicine is a revolutionary approach for disease prevention and treatment that takes into account individual differences in lifestyle, environment, and biology. While some advances in precision medicine have been made, the practice is not currently in use for most diseases.
The All of Us Research Program is a key element of the Precision Medicine Initiative (PMI). Through advances in research, technology, and policies that empower patients, the PMI will enable a new era of medicine in which researchers, health care providers, and patients work together to develop individualized care.
PMI launched in fiscal year 2016 when $130 million was allocated to NIH to build a national, large-scale research participant group, called a cohort, and $70 million was allocated to the National Cancer Institute to lead efforts in cancer genomics as part of PMI for Oncology.
A set of core values is guiding the development and implementation of the All of Us Research Program:
- Participation is open to all.
- Participants reflect the rich diversity of the U.S.
- Participants are partners.
- Trust will be earned through transparency.
- Participants have access to their information.
- Data will be accessed broadly for research purposes.
- Security and privacy will be of highest importance.
- The program will be a catalyst for positive change in research.
The All of Us Research Program seeks to extend precision medicine to all diseases by building a national research cohort of one million or more U.S. participants. Many factors have converged to make now the right time to begin a program of this scale and scope.
Americans are engaging in improving their health and participating in health research more than ever before, electronic health records have been widely adopted, genomic analysis costs have dropped significantly, data science has become increasingly sophisticated, and health technologies have become mobile.
All of Us is a participant-engaged, data-driven enterprise supporting research at the intersection of human biology, behavior, genetics, environment, data science, computation and much more to produce new knowledge with the goal of developing more effective ways to treat disease.