Star Tribune
Genetic discoveries map out your health risks, if you can keep up with them
Genetics discoveries are rapidly identifying the people at greater risk for cancers and other diseases, but researchers at HealthPartners are concerned that they are happening too fast for doctors and patients to keep up.
The Bloomington-based health care provider is testing a new alert system to close that knowledge gap by identifying patients with inherited risks for diseases and automatically alerting their doctors of their need for testing. Screening guidelines changed three times in the past 18 months, just for breast and ovarian cancers, after researchers identified genetic variants that increased risks of those diseases, said Dr. Patrick O’Connor, a senior researcher with HealthPartners Institute.
“There is a risk of information overload,” O’Connor said. “That’s why we’re creating a system to help organize these data in a way that’s clear to patients so they can make informed decisions about treatment options that may be of benefit to them.”
Using a $3.2 million federal grant announced earlier this week, HealthPartners hopes its alert system will hasten testing, which in turn will hasten diagnosis and treatment of diseases before they become severe or fatal. The goal is precision medicine — tailoring treatments based on patients’ unique circumstances — but O’Connor said there are many examples in health care now when that approach is underused.
Research has identified numerous genetic variants that affect the course of type 2 diabetes, for instance, but those nuances aren’t widely used right now to customize treatments, O’Connor said. Antidepressants are dispensed at a common starter dosage without consideration of the known variants that can dictate how well they will work, he added.
HealthPartners’ study will identify patients at 40 clinics in Minnesota and western Wisconsin who haven’t followed up on genetic testing results, even though they have one of seven variants linked to elevated risks of breast, colon or ovarian cancers. Doctors at 20 of those clinics will be prompted by the new alert system to talk with these patients about recommended tests or treatments. Researchers expect that these patients will receive more recommended screenings over the next three years than a comparison group of patients at the 20 other clinics that aren’t receiving alerts.
‘Difference can be gigantic’
Genes are chemical strands that program the body’s cells based on hereditary information passed down from parents to children. Millions of variations alter how genes work in the body, but a much smaller portion has been linked through research so far to elevated rates of disease.
The Centers for Disease Control and Prevention recommends testing for 11 genetic variants that have proven links to cancer or heart disease, including the variants of the BRCA1 and BRCA2 genes that are closely tied to breast cancer. The American College of Medical Genetics and Genomics lists 81 variants that should be reported to doctors and patients because of their links to treatable conditions.
If HealthPartners’ system works, it will be expanded to alert patients to other clinically important variants. Some only cause minute shifts in disease risks, while one known variation can increase lifetime risk of ovarian cancer from 1% to 70%. Another can identify smokers who have the best chance of reducing heart attack risks if they quit their habits.
“The difference can be gigantic in some cases,” O’Connor said.
Deenya Craig, 52, of Maple Grove didn’t hesitate when testing identified a BRCA2 mutation that increased her cancer risks and explained her family’s tragic history with the disease. One cousin recently died from prostate cancer while another struggled with an aggressive breast cancer. The result “opened doors that previously had been closed,” she said, including consultations with cancer specialists and insurance coverage of preventive treatments. She had a mastectomy last year to remove breast tissue that posed cancer risks, and had a gynecological procedure this month to reduce her risks for ovarian cancer.
Craig spread the word of her results, and now her sisters and three of her six children have been tested. Her whole genome testing of thousands of genes at once produced other interesting information about her susceptibility to caffeine and sleep disturbances, but mostly she said she felt empowered by the knowledge about her cancer risks.
“It gives the control back to you over your health instead of sitting and wondering what, if or when,” Craig said.
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More genetic testing
Craig received free testing through HealthPartners’ partnership with California-based Helix Inc. to gather genetic data from 100,000 volunteers. The myGenetics program is designed to alert volunteers to health risks but also amass genetic information for further identification of troublesome variants. Out of 40,000 volunteers, testing has found more than 600 with inherited risks for breast, colon or ovarian cancers.
Mayo Clinic will soon publish interim data from a similar project called Tapestry, which is recruiting 100,000 volunteers from its campuses in Minnesota, Arizona and Florida to identify those with any of the 11 CDC-identified variants. Results will show how many people with these variants wouldn’t have qualified for screening under current insurance and health system guidelines, said Dr. Jewel Samadder, co-director of precision oncology at Mayo Clinic’s cancer center in Arizona.
Mayo also will be following 15,000 of these patients over five years to compare their health and health care spending with patients who don’t have any of the variants. Screening just for the breast cancer variants used to cost $5,000, but now tests of thousands of genes at once cost around $500. Samadder said health systems will need to expand to account for a new generation of patients who are acting on this affordable genetic information.
Some studies already estimate that the cost is low enough to warrant widespread testing because it will end up saving money by identifying cancers before they require high-cost treatments.
Star Tribune
Trump is set to respond to Harris on immigration during his visit to a small Wisconsin town
Republicans including U.S. Sen. Derrick Van Orden, who is from Prairie du Chien, have criticized authorities in both Minneapolis and Madison for letting Coronel Zarate go, saying they essentially allowed him to attack the woman in Prairie du Chien. They have accused both jurisdictions of being sanctuaries for people in the country illegally.
Michelle Marie Dietrich, a public defender representing Coronel Zarate in the Prairie du Chien case, declined to comment. Charlotte Wynes, another public defender representing him in Prairie du Chien along with Dietrich, didn’t respond to a voicemail seeking comment. Michelle Brandemuehl, a public defender representing him in Madison, also didn’t respond to a voicemail message seeking comment.
Trump has repeatedly portrayed migrants as criminals and blamed Harris for failing to stem an unprecedented surge in illegal immigration, though border crossings have fallen since President Joe Biden instituted an executive order limiting asylum claims. Democrats, in turn, have blamed Trump for persuading allies in Congress to kill bipartisan legislation that would have funded more border agents and given the Homeland Security secretary authority to prohibit entry for most people over a daily limit.
One option presented to some vendors has been to register for the state’s Cottage Food Producer permit, based on a 2015 law that allows people to “make and sell certain nonpotentially hazardous food and canned goods in Minnesota without a license.”
Chavez said that’s a step in the wrong direction. Such a permit would allow vendors to sell homemade baked goods and pickled fruits and vegetables, but still wouldn’t allow them to operate on city sidewalks or in traffic.
“People might apply, but it isn’t actually going to address the root issue that people are struggling with,” he said.
The issue is one of equity according to Chowdhury, who said some vendors don’t have the necessary knowledge or resources because they’re still new to the country. Licensing or permit fees become barriers for new vendors trying to become compliant.
“When it comes to folks that are immigrants, new to our community, that’s an incredible barrier. So if we’re going to do economic empowerment, that’s the barrier that we want to help resolve, and so I’m 100 percent supportive of waiving these fees,” she said.
A street vendor near Lake Street and Portland Avenue in south Minneapolis. (Dymanh Chhoun, Sahan Journal)
Claudia Lainez, workers’ center director at COPAL, a Latino advocacy organization, said they have been monitoring the growth of street vendors across the metro area specifically because many are undocumented. She said vendors tend to be women because men, even undocumented, typically struggle less to find work.
A Minneapolis family is grieving after their 34-year-old husband and father died Thursday when he was struck by an SUV while riding an electric scooter.
Benjamin Nyman Walker was weaving through traffic while headed south on Nicollet Avenue near Interstate 494 when he was struck by a southbound Jeep Wrangler at 5:44 p.m., Richfield police said. Police, emergency workers and HCMC paramedics tried to save Walker, but he died at the scene.
An organizer collecting funds to support the family said Walker was on his way home from work when he was killed. Walker’s wife, Crystal, said he was a loving man who was quick to tell dad jokes and quicker to help others.
“He would give you the shirt off of his back in times of need. He was someone who was there to listen and give his truth,” said Crystal Walker, adding that the two had been planning to move to Wisconsin. “He was the light in any room when he was happy, and he tried his hardest to always make sure he kept everyone’s spirits up.”
“Being without him is going to be a lot harder than I thought it would be,” said Walker’s daughter, Karissa. “He was so sweet and he always cared about other people’s feelings.”
A similar scooter accident led authorities to arrest a woman in Texas for fatally injuring 52-year-old Andre Zedrick Steward in a July hit-and-run collision in Minneapolis. The woman told a witness that she was driving drunk when she hit a man, adding that she and her sister had fled the scene and flown to Las Vegas.
Staff writer Paul Walsh contributed to this report.
