Is There a Role for Genetic Testing in Sports?

Abstract

The last 15 years have witnessed a boom of genetic tests for sport performance. They relate to both the ability to predict athletes at higher risks for specific injuries, and to the ability to predict athletic talent. They raise scientific and ethical issues related to confidentiality, conflict of interest of the sports physician, informed consent in children and the possible infringement on the athlete's autonomy. We distinguish here genetic tests for injury prevention in four cases: (1) concussion‐related traumatic brain injuries; (2) sudden‐cardiac arrest‐related conditions; (3) overexertion complications related to the sickle‐cell anaemia trait; (4) Achilles tendinopathies and anterior crucial ligament ruptures. In addition, we discuss direct‐to‐consumer genetic tests for athletic performance prediction in children. We argue that although the former kind of genetic tests has utility, within the bounds of specified limitations, the latter is both ethically and scientifically problematic.

Key Concepts:

  • Genetic tests, whether administered by a doctor or as a direct‐to‐consumer product, cannot accurately predict an individual's predisposition to a greater risk of concussion, and should not be used in deciding whether or not athletes should return to play after a traumatic brain injury.

  • Genetic testing can play an important role in evaluating an athlete's risk of sudden cardiac‐arrest‐related conditions and could be included in rigorous preparticipatory screenings, but they should not be used as the basis for mandatory exclusion of individuals from participation in professional sports as that would constitute an infringement of their autonomy.

  • Genetic screening for sickle cell anaemia trait is able to identify individuals at higher risk of developing possibly fatal overexertion complications on the field of play. The mandatory genetic screening for the sickle cell trait as that put in place by NCAA should make sure not to discriminate against carriers of the trait and, in particular, not to target African‐Americans where the prevalence of the trait is higher. The NCAA should consider extending the screening to student athletes of all Divisions.

  • Genetic tests for an athlete's predisposition to Achilles tendinopathies and anterior cruciate ligament (ACL) injuries can and should be incorporated in a multifactorial risk model for the prediction of individuals at higher risk of this kind of injuries and for personalised training and prevention, but it should be noted that this kind of tests are not diagnostic in nature and that other nongenetic factors should always be taken into account in the prediction of individuals at a higher risk of developing injuries of Achilles tendon and ACL.

  • DTC genetic tests claiming to be able to predict athletic performance or athletic potential make overstated marketing claims and should not be taken seriously. In addition, they raise specific problems of informed consent in children, and of confidentiality and informed consent when used in the context of professional sports medicine.

Keywords: DTC‐genetic tests; sudden cardiac arrest; talent; traumatic brain injury; Achilles tendinopathy; anterior crucial ligament rupture; concussion; sickle‐cell anaemia; children; autonomy; return to play

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Further Reading

Camporesi S and McNamee MJ (2012) Gene transfer for pain: a tool to cope with the intractable, or an unethical endurance‐enhancing technology? Genomics, Society & Policy 8(1): 20–31.

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Tucker R and Collins M (2012) What makes champions? A review of the relative contribution of genes and training to sporting success. British Journal of Sports Medicine 46: 555–561. doi:10.1136/bjsports‐2011‐090548.

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How to Cite close
Camporesi, Silvia, and McNamee, Michael J(May 2013) Is There a Role for Genetic Testing in Sports?. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0024203]