We have just made some updates to the deCODEme ancestry service. Now you have more power and flexibility when you compare your genome with that of friends or individuals from different populations around the world.

Your genome can be viewed as a mosaic or tapestry made up of fragments of chromosomes from your ancestors. Fragments of chromosomes inherited from very recent ancestors, say grandparents, are expected to be large – typically tens of millions of nucleotides in size. As ancestors become more ancient, then the size of the chromosome fragments inherited from them become smaller – down to a few thousand or hundred nucleotides for ancestors born thousands of years ago.

Our new and improved genome comparison tool enables to you compare your genome with another individual in order to determine which chromosome fragments you share and to see how much of your genome is shared. The fascinating thing about this analysis is that each shared fragment represents a common ancestor. The number of shared fragments and their size reflects the number of common ancestors and how far back in time they are found. In other words, you can see how closely you are related.

When genomes are compared, your chromosomes are broken down into fragments of a particular size and sharing is evaluated for each fragment. Before the fragment size was fixed at 1 million nucleotides. Now you can change the size of fragments that are compared, from a minimum of 250 thousand nucleotides (250Kb) to a maximum of 20 million nucleotides (20Mb). The minimum fragment size will reveal shared chromosome fragments from common ancestors going back thousands of years. The maximum fragment size will reveal only shared chromosome fragments from very recent common ancestors – i.e. going back only a few generations. Setting the fragment size thus lets you select how far back in time you want to hunt for common ancestors.

This image shows results of a comparison between an Icelander and an Orkney Islander using a fragment size of 3Mb. The brown lines are shared fragments, inherited from common ancestors from more than 1000 years ago!

deCODEme DNA test now includes Ovarian Cancer

Ovarian cancer is the eighth most common cancer in women. Based on ovarian cancer statistics in the U.S., it is expected that 1.4% of women born today will be diagnosed with cancer of the ovary at some point during their lifetime. This represents the lifetime risk of ovarian cancer and means that 1 out of every 71 women will be diagnosed with this disease during their lifetime. deCODEme Complete Scan now includes risk calculation for Ovarian Cancer.

Genetics is a major risk factor for ovarian cancer

Although many environmental and lifestyle factors affect the risk of ovarian cancer, the single greatest known risk factor is a family history of the disease. This indicates that genetics is a major risk factor. Scientists already know that variants in the BRCA1 and BRCA2 genes significantly increase a woman’s chances of developing ovarian cancer. However, these variants are rare and account for less than 5% of all ovarian cancers. Recently, scientists have discovered a common variant on chromosome 9 that can increase a woman’s risk of developing the most common type of ovarian cancer (epithelial cancer). This variant is found in approximately 70% of women of European descent.

deCODEme calculates your genetic risk for Multiple Sclerosis

The Multiple Sclerosis Association of America (MSAA) encourages Multiple Sclerosis (MS) Awareness during March 2009.

Multiple sclerosis (MS) is the most common neurological disorder diagnosed in young adults.  It is an inflammatory disease of the central nervous system; the brain, nerves and spinal cord, that damages the protective insulation (known as “myelin”) surrounding the nerves. As a result, nerve impulses carrying messages from the brain and spinal cord are disturbed, causing a variety of symptoms such as visual disorders, weakness, dizziness, and various movement disorders, to name but a few.

The causes of MS are not fully understood. With better understanding of the disease, more effective ways will be found to treat it in the future, and hopefully prevent it from occurring in the first place. Significant steps towards better understanding of MS have however been made.

Researchers have for example found that although the disease is not directly inherited, genetics play an important role in who gets the disease.  Studies have revealed that the risk of developing MS for an average person is 1/750 but the risk rises to 1/40 for a person who has a first-degree relative (parent, sibling, child) with the disease. Even though identical twins share the same genetic makeup, the risk for an identical twin is only 1/4, showing that factors other than genetics are involved.

The deCODEme Complete Genetic Scan includes a test that calculates a person’s genetic risk for MS according to the best scientific data available to date. While the test cannot determine whether you will or will not develop MS, it can, on the basis of a comparison of your personal genetics to the genetics of large groups of people with and without MS, give you an estimate of your lifetime risk of developing this disease. This, combined with other risk factors, can give you an estimate of your overall risk.

Other factors involved in the development of MS that have been identified are

• MS is more common in people of Northern European descent than in people of other ethnicities, and more common in women than men.

• Viruses and bacteria have been suspected of contributing to the development of MS because patients with MS typically have a higher number of immune cells than a healthy person. Some researchers theorize that MS may develop in genetically susceptible people, after they have been exposed to a viral or bacterial infection.

• MS is more common in countries with temperate climates, including Europe, southern Canada, northern United States, southeastern Australia and New Zealand. The reason for this is unknown, but geographic studies suggest that it may be due to environmental factors, genetic factors, or both.

Visit The Multiple Sclerosis Association of America for more about the disease
Visit deCODEme to learn more about the Multiple Sclerosis Genetic Test.

Crown Prince Frederik of Denmark and Crown Princess Marie of Denmark along with deCODE scientist Unnur Thorsteinsdottir during an official visit to deCODE laboratories earlier this year.

Reykjavik, ICELAND, December 8, 2008 – deCODE genetics (Nasdaq:DCGN) today announced the discovery by an international consortium of scientists from deCODE and major European and US academic institutions of a single letter variation in the human genome (SNP) that is associated with increased fasting glucose levels and risk of type 2 diabetes (T2D). deCODE will employ its CLIA-registered genotyping laboratory and existing testing platform to swiftly integrate the finding into its deCODEme™ personal genome scan, and to assess the addition of this new variant to the company’s deCODE T2™ reference laboratory test for assessing individual risk of type 2 diabetes.

The multinational study analyzed a number of SNPs that had been suggestively linked with fasting glucose levels in several major studies involving some 36,000 individuals from Europe and the United States.The analysis identified a version of single SNP within the gene encoding melatonin receptor IB (MTNR1B) that was associated with notable increase in fasting glucose levels. The deCODE team then demonstrated in its Icelandic cohort that this SNP also associated with an increased risk of T2D, a finding that was then replicated in a meta-analysis of data from more than 80,000 cases and controls from Europe and the US. Approximately 10% of the participants in this study carry two copies of the at-risk version of this SNP, putting them at more than 15 percent greater risk of type 2 diabetes than individuals who carry no copies. The paper, entitled “Variants in MTNR1B influence fasting glucose levels,” is published today in the online edition of Nature Genetics, and will appear in an upcoming print edition of the journal.

“This finding is another step towards rounding out our understanding of the genetic factors that underpin glucose regulation and risk of type 2 diabetes. This variant does not confer sufficient risk to be of clinical utility on its own. But when measured in addition to our TCF7L2 variant that is the anchor of the deCODE T2™ test, it may, like other common variants conferring modest risk, enable the test to capture an even larger proportion of inherited risk. We are currently evaluating its integration into deCODE T2™, because understanding genetic risk of T2D enables individuals and their physicians to focus, personalize and improve prevention. In the meantime, we will be enabling our deCODEme subscribers to check their profiles for this new variant, keeping them at the cutting edge of human genetics” said Kari Stefansson, CEO of deCODE.

Type 2 diabetes: A major public health problem
T2D is a chronic condition that develops when the body either becomes resistant to or doesn’t secrete enough insulin. Diabetes affects nearly 200 million people worldwide and, according to the American Diabetes Association, some 21 million in the United States. The vast majority of these have T2D, and as many as one third of Americans with diabetes may not even be aware that they have the disease. More than 50 million Americans have pre-diabetes, a condition characterized by elevated blood glucose levels and which puts these individuals at high risk for developing T2D. T2D can be managed and – most importantly – prevented. If losing weight, eating better and getting adequate exercise aren’t enough, there are also medications that can help to manage blood sugar levels and insulin response to reduce the likelihood of developing diabetes. For more information on T2D and how to prevent it, you can go to the American Diabetes Association’s website.

Amy Doneen, Director of the Heart Attack & Stroke Prevention Center, Spokane, WA.

Amy Doneen at the Heart Attack and Stroke Prevention Clinic in Spokane, Washington, talks about an “exciting new time” for preventive health care. Amy, a nurse practitioner, has been using nutrigenomics (the response of genes to nutrition) as part of the program for more than a decade and with outstanding results. “The goal,” says Amy “is to find out what path a patient is on to developing certain diseases and kick them off that path.” Scanning for risk factor for common conditions (such as diabetes, heart attack, several types of cancer etc.) She emphasizes the importance of gauging lifetime risk as against clinical tests that usually concentrate on immediate high risk. According to Amy, some people walk away from the second kind with a negative result and think things are always going to be fine. Genetic testing is just arriving to the market place, but Americans currently spending nearly $50 billion on stroke care alone, the time is ripe to back all advances in preventive medicine.

To read more and watch parts of the interview with Amy Doneen visit the deCODEme Customer Stories.

deCODE Breast Cancer enables women to understand whether they may benefit from more intensive screening, monitoring or preventive drug therapy.

Reykjavik, ICELAND, October 8, 2008 – deCODE genetics today announced the launch of deCODE BreastCancer™, a new tool for assessing risk of the common forms of breast cancer. For the first time, a woman concerned about breast cancer can speak with her physician about a genetic test to better understand her lifetime risk of developing the common forms of the disease.

The common forms of breast cancer result from the interplay of genetic as well as environmental and lifestyle factors and represent 95 percent of all breast cancers. These are distinct from the rare and essentially purely inherited forms of the disease due to mutations in the BRCA1 and BRCA2 genes, which cause between 1 and 3 percent of breast cancers. deCODE BreastCancer™ is a DNA-based reference laboratory test performed using a simple blood sample or cheek swab, ordered by physicians on behalf of their patients.

“This test is simple and compelling because it provides a woman and her doctor a means of understanding her personal risk of developing the common forms of breast cancer. This information is well-validated, relevant to the vast majority of women, and independent of family history and other known risk factors. Combined with the high public awareness of the importance of screening, advances in magnetic resonance imaging (MRI) technology and the availability of preventive drugs targeting estrogen receptors, I believe this test will help to save lives,” said Dr. Kari Stefansson, M.D., Dr. Med., CEO of deCODE.

“DNA-based breast cancer risk assessment has to date been focused on detecting rare mutations that confer very high risk of early onset breast cancer. These are very valuable tests, but they do not measure genetic risk of the common forms of the disease.  The DNA markers identified recently by deCODE represent an important step toward filling current gaps in our understanding of breast cancer risk.  Ultimately, the goal is to deliver more personalized prevention and treatment for a much greater number of women,” said Rebecca Sutphen, M.D., Clinical Geneticist at Moffitt Cancer Center and Advisory Board member at Informed Medical Decisions, Inc., a network of genetic counselors who provide support to physicians and patients using deCODE’s tests.
“We speak to many people who are concerned about breast cancer through our 24/7 YourShoes Breast Cancer Support Center,” said Margaret C. Kirk, CEO, Breast Cancer Network of Strength (formerly known as YME National Breast Cancer Organization). “We are very interested in all advances that could empower people to take charge of their health care and better understand their risk for developing breast cancer.”

Owen Winsett, M.D., founder and director of the Breast Center of Austin, Texas, commented: “I have followed closely the recent scientific discoveries that are incorporated into this test. I am excited to be able to extend my screening and prevention practice, because this test applies to so many more women than the BRCA1 and BRCA2 tests. My patients are eager for this type of risk information and appreciate that the test can be done with a painless inner-cheek swab. I have ordered several tests on an early-access basis and plan to make this test a standard tool for helping me to decide which of my patients may benefit from screening at an earlier age, breast MRIs, and other risk reduction measures. This test helps define individual prevention, which is what so many of my patients want.”

The deCODE BreastCancer™ test measures seven widely replicated single-letter variations (SNPs) in the human genome that deCODE and others have linked to risk of breast cancer. These SNPs contribute to the incidence of an estimated 60 percent of all breast cancers. The test integrates data from discovery and replication studies published in major peer-reviewed journals and involving nearly 100,000 breast cancer patients and healthy volunteers from many populations, principally of European descent. deCODE and other organizations are conducting replication studies to validate these markers in populations of other continental ancestries.

Women taking the deCODE BreastCancer™ test will receive a numerical score representing their relative risk of developing breast cancer in their lifetime compared to that of the general population as well as their personal lifetime risk. According to the American Cancer Society, average lifetime risk for women of European descent is 12 percent. Test scores range from 4.0 times average lifetime risk to less than half, or 0.4-times. The risk assessed by deCODE BreastCancer™ is independent of conventional risk factors such as family history of breast cancer in close relatives, age at first menstrual period, pregnancy history, and breast density. Therefore, this genetic risk should be viewed in the context of other risk factors assessed by a woman’s physician.

deCODE BreastCancer™ can identify the roughly 5 percent of women who are at a greater than 20 percent lifetime risk of the common forms of breast cancer (about twice the average risk in the general population), and the 1 percent of women whose lifetime risk is roughly 36 percent (about three-times average). According to ACS guidelines, women with a lifetime risk of 20 percent or greater should receive annual MRI breast screenings in additional to mammograms, and women at 15 to 20 percent lifetime risk should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. With the information provided by the deCODE BreastCancer™ test, an additional 15 percent of women may fall within this range of moderately increased risk.

The test also predicts which women are more likely to develop ER-positive breast cancer if they develop cancer at all. This is important because these women may be more likely to respond to prevention strategies with drugs like tamoxifen that target estrogen receptors. The American Society of Clinical Oncology (ASCO) recommends that women with a five-year risk of 1.66 percent or greater should be considered for preventive treatment with tamoxifen.

deCODE BreastCancer™ may also be used to modulate the risk profile of the early onset inherited forms of breast cancer in women who have tested positive for risk variants in the BRCA1 or BRCA2 genes.

How to order deCODE BreastCancer™
Additional information and physician order forms for deCODE BreastCancer™ can be found at www.decodebreastcancer.com. The price of the test is $1625 dollars and deCODE facilitates filing for reimbursement with commercial insurers. Testing is performed in deCODE’s CLIA-registered laboratory, which has analyzed the genomes of hundreds of thousands of people from around the globe.

About Breast Cancer
Breast cancer is the most common cancer and the second leading cause of cancer deaths among women, according to the World Health Organization. The ACS estimates that 182,400 new cases of invasive breast cancer will be diagnosed in the United States in 2008, resulting in more than 40,000 deaths.

Breast cancers are classified as ER-positive or ER-negative according to whether tumors are found to contain estrogen receptors. In women of European descent, approximately three-quarters of breast cancers are ER-positive, and in women of African descent, approximately 50 percent are ER-positive.

Although a substantial portion of risk of breast cancer is inherited, it has taken painstaking research to find genetic variants predisposing to the disease’s common forms. The mutations in the BRCA1 and BRCA2 genes conferring very high risk have a less than 0.5 percent frequency in the general population in the United States and Europe, accounting for only 1-3 % of all breast cancers.

Identifying and enabling the detection of a substantial proportion of the genetic risk for the common forms of breast cancer is the goal of deCODE’s gene discovery work in breast cancer and the deCODE BreastCancer™ test. Women who know they are at a higher than average risk of breast cancer can also make proactive lifestyle changes to lower their lifetime risk, according to ACS. These include staying physically active, maintaining a healthy weight, eating healthy foods, and limiting alcohol intake and smoking.

About deCODE
deCODE is a biopharmaceutical company applying its discoveries in human genetics to the development of diagnostics and drugs for common diseases. deCODE is a global leader in gene discovery — our population approach and resources have enabled us to isolate key genes contributing to major public health challenges from cardiovascular disease to cancer, genes that are providing us with drug targets rooted in the basic biology of disease. Through its CLIA-registered laboratory, deCODE is offering a growing range of DNA-based tests for gauging risk and empowering prevention of common diseases, including deCODE T2™ for type 2 diabetes; deCODE AF™ for atrial fibrillation and stroke; deCODE MI™ for heart attack; deCODE ProCa™ for prostate cancer; deCODE Glaucoma™ for a major type of glaucoma; and deCODE BreastCancer™ for the common forms of breast cancer. deCODE is delivering on the promise of the new genetics.

Scientists at deCODE genetics Genetic Service Facility lab in Iceland

The number of companies offering genetic tests to the public is large and growing. But there are vast and very real differences in the quality, purpose and price of testing services out there. So how do you tell the difference between them? And how do you decide which to use?

Knowing what you want

First and foremost, you need to think about what sort of information you hope to gain from your genome and how accurate you want the results to be. Are you taking the test only for fun, perhaps hoping to talk about your results on Facebook? Or are you interested in using it to protect or improve your health, perhaps working with a doctor? And do you want your information to be kept strictly private so that you are in full control of those with whom you share it, or are you comfortable with others being able to access it and use it?

At deCODE, we have studied the genomes of hundreds of thousands of people over the past twelve years. Our goal has been to discover what variations in the human genome give some people higher or lower than average likelihood of developing many of the most common diseases in our society. We use that information to develop products like genetic tests that can help people to stay as healthy as possible for as long as possible. From day one that’s been our bread and butter – it’s not an idea that occurred to us last week or even last year.

And with that experience, and having worked with so many people, there are a few basic things that we think you should look for in any genetic testing service. These are fundamental characteristics that we demand of ourselves in all of our discovery work, and we think you should settle for nothing less.

Buyer’s checklist

In any field, in order to offer services to the public you have to be able to stand behind the quality of your product. In genetic testing, the basis of any test worth paying for is good science: large-scale studies that establish and then replicate in independent groups links between specific markers in the genome and specific traits, such as diseases. Making those links requires gathering large sets of very high quality, consistent data. It requires teams of doctors, geneticists and other scientists, as well as certified DNA analysis laboratories, statistical tools and computing power and software to accurately analyze the datasets. If you can do all this under the strictest data and privacy protection protocols in the world, you will reward the participation of your research subjects with peace of mind they deserve.

That’s just for starters. In order to offer a test, you need to be give your customers the same certified quality of DNA analysis, as well as the ability to accurately interpret what the findings of large studies mean for disease risk. In short, you need all the same capabilities and expertise as for research, but focused on accurately and securely delivering results to individuals.

The gold standard

These are the standards that lie behind deCODEme and all our diagnostic tests. We offer the best science, usually our own, as our scientists lead the world in finding genetic risk factors for common diseases. Where we do use discoveries made by others, our scientists have validated the findings according to our own rigorous criteria. We have our own CLIA-certified DNA analysis laboratory, one of the largest of its kind in the world, and do our own quality control. We share your results with no one but those you specifically request. We offer our customers the ability to check whether they carry validated risk factors for dozens of diseases, and update their profiles rapidly and regularly as new discoveries are made. This isn’t trivial stuff, and our prices reflect the quality of the products we offer.

Don’t just take our word for it: the value of deCODE tests is reflected most clearly in the stories of customers like you. On this blog you can read about what they have to say about how they are using their results to better look after their own health.

Your genome, your choice

This is a high bar, and one that few others will pass. Can you find cheaper services out there? Yes. Are there dot-com storefronts that outsource the science and the analysis of your genome? Yes. That are focused less on quality and more on website bells-and-whistles for using your genome for social networking? Yes again.

But your genome is yours, and we think you have a right to choose the best for yourself if that’s what you want. At deCODE we are not offering cut-rate services, outsourcing the analysis of your genome, or cutting corners on privacy protection. We give you a portal into the best and latest in genetics, offering the highest quality services available for those who want to know how the latest breakthroughs in human genetics can be used to improve their health and healthcare. If that’s you, we encourage you to check how other services stack up to deCODE – and we look forward to hearing from you!

Here are a few thoughts on Nic Fleming’s piece on personal genome scans, of which one was our own, deCODEme:

Our genomes are all remarkably similar. And so it is the differences that are most interesting and important, and that make us who we are.

The same can be said of genetic testing services. We at deCODE were not at all surprised that Mr. Fleming found that he got some varying results from the three genome scans that he tried. Indeed we would be surprised (and more than a little dismayed) if he hadn’t. Analyzing the genome – accurately detecting which genetic markers individuals have at specific points in the genome, and correlating these variations with risk of a range of common diseases – has been our bread and butter for well over a decade. With the analysis of hundreds of thousands of genomes under our belt, we can say with some authority that it is not a trivial business. We would never ourselves rely on consultants to tell us what variants to look for, what they mean, or to oversee the genotypic analysis itself. And we certainly would not offer such treatment to doctors or members of the public.

That said, it would be a strange logic that therefore suggests that the whole field, or the very well validated science that now exists linking specific markers to risk of common diseases, should be lumped in together as though all are nothing but dot-com storefronts selling DNA analysis today where they might have been selling sofas last year. deCODEme or our diagnostic tests, for example, only detect risk variants that meet exacting criteria: they must have been published in peer-reviewed scientific journals and replicated in large cohorts from several populations. Many genetic risk factors for common diseases have passed this high bar, and have thus been as well validated, as most non-genetic risk factors were when they were first brought into clinical use. As Mr. Fleming notes, there are physicians who are incorporating genetic risk factors into their clinical practice and with some important successes that individuals have been willing to share with the world. (We are posting some of these stories on this blog and on the personal stories page of deCODEme).

So, as suggested by Mr. Fleming’s piece and by Lord Taverne and others he interviewed, it is of pressing importance to establish high scientific and technical standards and regulations for such tests. We therefore hope that the Human Genetics Commission, and other oversight bodies in Europe, the US, and elsewhere will continue to scrutinize how best to provide an effective sheriff for this new territory. Doing so will enable individuals and the healthcare system to take full benefit from the potential of this new technology, while protecting the public from unscrupulous cowboys. At the least – since some people like cavorting with fun-loving bandit types – everyone would know who was who.

Edward Farmer
Chief Communications Officer
deCODE genetics