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Sign Up for FORCE NewslettersChoosing the Right Test
Genetic testing is not one-size-fits-all. Different labs offer different types of tests. Choosing the right test is complex. You should consult with a genetics expert before testing to assure that the right test is ordered from a reputable lab. Below are some considerations:
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Which genes are included?
Some genetic tests look for just one or a few specific gene mutations. Other tests, known as "multigene panel tests," look for mutations in many genes at the same time. It's important to understand which genes are included in the test before your genetic test has been ordered and after you receive your test results. Larger panels are not always better. Some of the genes included in larger panel tests have been studied less and their impact on cancer risk may be unknown. A genetics expert can help you decide which test is best for your situation.
For more information, visit our page on the genes associated with different types of cancer.
Which lab should I use?
Many different labs offer genetic testing for risk. It is important to use a reputable lab that is certified by the College of American Pathologists (CAP) or Clinical Laboratory Improvement Amendments (CLIA). Reputable genetic testing labs include:
- Ambry
- Color
- Exact Sciences
- InVitae
- Myriad
Labs may use different methods to test for mutations. The testing method may affect the cost, accuracy and time it takes to get results. Genetic test results usually take two to three weeks. Most labs offer quicker results for people who need the information to make urgent treatment decisions.
Often labs will contract with healthplans, so your insurance company may determine which lab is used.
Be cautious about signing up for genetic testing at health fairs. Sometimes less reputable labs will sell their tests directly to the public at health fairs with little oversight from doctors or genetics experts.
If you have had a bad experience with a lab, you can file a complaint with CLIA or the . Learn more about this process here.
Cost of testing
The cost of a genetic test may depend on the lab performing the test, the type of test ordered, your health insurance coverage and whether or not you meet testing guidelines. Insurance will usually cover the cost of genetic testing, but out-of-pocket costs may vary. Most people can get genetic testing for $250 or less. You can learn more about paying for genetic testing here.
Using ancestry testing for cancer risk
Ancestry testing is a type of genetic testing that helps people find relatives or learn more about their ethnicity. These tests are sold for recreational purposes only. They are not meant to guide medical decisions.
Some ancestry testing companies may offer limited testing for a small number of mutations in , and some genes that are linked to Lynch sndrome. Ancestry tests do not look for many of the other gene mutations that may be linked to cancer. For example, there are almost 3,000 known mutations in and over 3,300 known mutations in . Ancestry tests only look for a few of these. Other genes, such as and are not included in the current ancestry tests.
The warns people not to use ancestry test results to make medical decisions, and advises individuals to have testing with a clinically certified lab to confirm the results. The agency also emphasizes “it is important for patients to consult their health care professional who can help them understand…their individual cancer risk.”
Testing within research
Participating in genetics research is a great way to contribute to science and improve care for future generations. Some clinical trials offer genetic testing as part of participation in the study. Genetic testing within research may differ from clinical testing through your doctor. Before participating in a research study, make sure you know the following:
- what are the goals of the study?
- what is required of participants?
- is genetic counseling included as part of the study?
- does the study cover the costs of genetic counseling and testing?
- which genes will be tested?
- will you receive your test results?
- who will have access to your test results?
- how long will it take to receive your results?
Learn about research studies that include genetic testing by visiting the list below.
In the News
March 15, 2018
June 14, 2022
Paying For Care
Insurance coverage for genetic counseling and testing
Most health plans cover genetic counseling and testing for inherited gene mutations linked to cancer in people who meet the national guidelines. The cost of testing and your out-of-pocket charges may vary based on several factors.
People who are denied coverage for genetic testing can file an appeal (FORCE has sample appeal letters). Your healthcare provider can work with your insurance company and help you file an appeal if needed. Low cost testing may be available for $250 or less. Learn more about coverage for genetic counseling and testing here.
If you need information about finding an insurance plan, watch our video: Choosing Wisely: How to Pick Insurance Plans.
testing under the Affordable Care Act
Under the Affordable Care Act (ACA), insurance companies must pay for both genetic counseling and testing with no out-of-pocket costs for women who meet certain criteria. The ACA regulations are limited to testing for and only and do not cover genetic counseling or testing in all situations. You can learn more about testing under the ACA here.
Medicare and Medicaid coverage of genetic testing
Genetic counseling and testing is typically covered by Medicare for people already diagnosed with cancer who are in treatment or for whom test results may affect their care. Most state Medicaid programs cover genetic testing for and mutations for people who meet requirements, which vary by state. You can read more about Medicare and Medicaid coverage of genetic testing here.
Financial assistance or low cost genetic testing
JScreen is a national program based out of Emory University that provides low-cost at-home genetic counseling and testing with financial assistance available. Many laboratories offer low-cost genetic testing or financial assistance programs. Programs vary, so if you are not eligible for assistance through one lab, consider contacting other labs to see if you qualify .