• 09.30.01

If the Gene Fits …

Future Tense: Personalized Genetic Testing

What exactly is in your genes? What does your genetic makeup say about your future? A generation ago, it was virtually impossible to answer such questions. Now potential answers are tumbling forth, thanks to dazzling advances in the mapping of the human genome. But like any new technology, its promise exceeds current performance. Costs are steep, the technology is delicate, and lead users (doctors) are only beginning to consider gene tests valuable for their patients.


Dr. Charles Strom wants to change all that.

As head of the molecular and biochemical genetics lab at the Nichols Institute, Strom runs one of the world’s busiest gene-testing sites. (Nichols is the main R&D arm of Quest Diagnostics, the largest medical-testing company in the United States.) Each week, his team analyzes more than 1,500 patient samples for evidence of genes that trigger cystic fibrosis, rare forms of deafness, and other disorders. In many cases, test orders are growing by more than 100% a year.

And that, says Strom, is just the beginning. He and his team are taking tests that took weeks to complete and turning them into high-throughput production runs. Such changes not only improve efficiency and accuracy, they also lead to stunning cost drops. Tests that seemed unaffordable at $300 apiece look much more alluring at $60 — and eventually at even less. That’s what Nichols does best. In its 30-year history, the lab has pioneered hundreds of tests that began as exotic experiments and soon became routine, reliable parts of mainstream medicine.

To be sure, there are tough questions ahead. Who will pay for such tests? How extensively should each person be tested? And who should have access to the results? Those issues notwithstanding, Quest has opened three walk-in clinics in Colorado, where curious people can order workups on themselves without a doctor’s order. Look ahead, says Strom, and genetic testing could become a routine part of a pharmacy visit. While you wait to get your prescription filled, a pharmacist could screen your genes and help determine whether the proposed medicine is right for you. “It may take 10 years or more,” Strom says. “But eventually, what we’re doing in this one lab could become standard throughout the country at the point of care.”

Contact Dr. Charles Strom by email (

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