Blog editor’s note: This #BlackHistoryMonth, 23andMe employees are celebrating joy and resilience in the Black and African diaspora through events, <a href="https://www.instagram.com/p/CZ2D0Z6JKWe/">art</a>, and conversations. We’ve also curated a series of guest blogs about people who embody that joy and resilience – and are harnessing these strengths to uplift their communities and create a better future. Today, we’re highlighting Nyema Clarks work in building a urban farm to build a community around wellness and connections to the land.
By Gennette Cordova
Tucked away in the Beacon Hill neighborhood of Seattle is <a href="https://www.nurturingrootsfarm.org/">Nurturing Roots</a>, a community farm  founded by  Nyema Clark in 2016 as part of a movement to reclaim her people’s history and relationship with agriculture.
“I feel like, as a Black woman, all I hear about is ‘roots’—that&#8217;s our engagement with agriculture,” says Nyema. “I wanted to find an alternative way to visit, to view, to think about agriculture.”
Growing up in the urban, multicultural community of Seattle’s South End, Nyema’s exposure to different cultures informed her view of the world and food, in particular.
“My neighborhood was very diverse,” she says. And that diversity extended to the kitchen. &#8221; At my kitchen table I was eating just about everything. My friend across the street might be making lumpia; I could get a soul food meal from grandma; or I was able to get authentic chicken soup from my Vietnamese neighbors.”
Nyema grew up in an environment that emphasized  all aspects of “growing.” Her mother, a florist, instilled in her the vital importance of growing professionally, mentally and emotionally. Her father, who was interested in landscaping and carpentry, exposed her to the practice of building with her hands.
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 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="576" src="https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0598_2-1024x576.jpg" alt="" class="wp-image-29526" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0598_2-1024x576.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0598_2-300x169.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0598_2-768x432.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0598_2-880x495.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0598_2-1180x664.jpg 1180w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0598_2.jpg 1920w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6>Addressing Disparities</h6>
“It’s always intrigued me. I always wanted to learn more, (about) Black folks in farming,” says Nyema. “Learning about George Washington Carver, the crazy land swaps and land grabs that happened. Identifying how structurally things are all messed up, I just dove head first into the agricultural side.”
In Seattle, like many cities around the country, health disparities such as higher instances of asthma among Black and Hispanic children can be attributed, in large part, to environmental racism. 
The evidence of racism and income inequality were evident throughout her childhood. “I don&#8217;t want to say it was a typical urban environment, because it was very unique. It was beautiful but also sucked knowing that a lot of my friends had asthma. And now I know why.”
Still, it was this environment that cultivated Nyema’s mind for business. Her entrepreneurial inclinations began with grade-school lemonade stands. That eventually led to the formation of her company, Avenue South, a small specialty seasonings shop at Seattle landmark Pike Place Market. While she enjoyed the exploration of value-added products, she became deeply invested in the idea of feeding her community with no monetary value attached. 
Nurturing Roots was the logical expansion of this investment.  The nonprofit has flourished, tended to by her commitment to “Robin Hood the system.” In this moment, where racial and social justice is under a magnifying glass, Nyema is intentional about addressing systematic oppression with an emphasis on food and environmental justice.
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 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="576" src="https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0475-1024x576.jpg" alt="" class="wp-image-29525" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0475-1024x576.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0475-300x169.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0475-768x432.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0475-880x495.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0475-1180x664.jpg 1180w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0475.jpg 1920w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6>Claiming Her 40 Acres</h6>
“A lot of my trauma was associated with realizing we were brought here in servitude,” she says. For many Black Americans, especially those of us who grew up in cities, we naturally connect Blackness and farm work to the hundreds of years of barbaric, American chattel slavery, that confined our ancestors to coffee, tobacco, cocoa, sugar, and cotton plantations. 
Nyema is resolved to reclaim farming as a means to reconnect with  history and healcommunities. To further this vision, she has turned her focus to land ownership. She recently received funding to purchase the commercial space that currently houses Nurturing Roots, and she’s close to sealing a land transfer deal with the Seattle Parks Department to obtain 38 acres called Red Barn Ranch in a suburb of Seattle. 
“My plan for Red Barn Ranch is to create a self-sustaining ecosystem that includes Black farmers, Black healers and young people,” she says. “I wanted to be able to start a fire under the city’s ass to get them moving.” adding “You guys have land and you&#8217;re not doing anything with it? We&#8217;re paying taxes on it and the community could use it? What are you doing?” 
For Black Americans, there’s a symbolism in coming into possession of nearly 40 acres—the amount of land, along with a mule, famously promised and then denied to former slaves. 
“That&#8217;s why I tell everybody it’s all of ours,” she says. “We all are about to get our 40 acres finally.”
In acquiring this space, she aims to attain financial security, freedom to carry out her purpose and conjure a spiritual remedy for a time when our ancestors could own nothing, not even themselves. 
“Personally, I&#8217;ve seen a lot of land taken from not only our community but my family. We had a house in the [city’s historically Black] Central District, it was foreclosed,” says Nyema, touching on a shared experience for many Black people in Seattle. 
“My model encompasses everyone being able to own a piece of land even though this document says Nurturing Roots on it,” she says. “We don’t have individual plots at Nurturing Roots. Someone asked me before, ‘can I come and grow my garlic there?’ And it&#8217;s like, ‘yeah, but it&#8217;s gonna be amongst all the other garlic and then anybody who comes can pick it. Are you okay with that?’” 
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 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="576" src="https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0357-1024x576.jpg" alt="" class="wp-image-29524" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0357-1024x576.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0357-300x169.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0357-768x432.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0357-880x495.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0357-1180x664.jpg 1180w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0357.jpg 1920w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6>Physical, Mental and Spiritual Wellness</h6>
Community is prioritized at Nurturing Roots, along with self-sufficiency and food empowerment. In South Seattle, the area’s lower income and higher unemployment predictably correlates with the sparseness of grocery stores, compared to other parts of the city. Beyond providing a much needed additional source for fresh produce, addressing a wide range of health issues from the expansion of access to nutrition-based education and fitness training to more ambitious goals like “taking control of our own sovereignty when it comes to healthcare” are on Nyema’s agenda.
<div id="attachment_29527" style="width: 250px" class="wp-caption alignright"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-29527" src="https://blog-api.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0607-240x300.jpg" alt="" width="240" height="300" class="size-medium wp-image-29527" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0607-240x300.jpg 240w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0607-768x960.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0607-819x1024.jpg 819w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0607-704x880.jpg 704w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0607-944x1180.jpg 944w, https://blogcms.23andme.com/wp-content/uploads/2022/02/23ANDME_01_15_2022_0607.jpg 1080w" sizes="auto, (max-width: 240px) 100vw, 240px" /> Photo by Meron Menghistab </div>
Understanding how isolating many corporate spaces can be for Black workers, she sees Nurturing Roots as an opportunity to give her loved ones an alternative to more traditional working environments. So far, she’s been able to staff her operation entirely with people who are dear to her, some who she’s enjoyed decades-long friendships with. Nyema envisions a communal system with currency based on bartering, exchanging labor on the farm or some other offering, with the hope that the community she creates can detach their sense of self-worth from a dollar amount. 
With Nurturing Roots, she is intentional about centering healing and health, not just through nourishment of the body but nourishing the mind and spirit, as well. After years of feeling constantly undervalued in professional settings, with her farming project she felt her identity—as a Black person, a woman, a South Seattle native—being celebrated in a way that she’d never experienced before.
“Spiritually, it&#8217;s like I&#8217;ve been restored doing this work—almost like a baptism,” she continues, moved to tears. “Now, I couldn&#8217;t go back and work for someone if I wanted to. I needed to value myself. I needed to explore being a strong woman and have it not look like something else. It was tough to find in these artificial spaces.”
With the region boasting a wide range of agricultural products and a growing emphasis on sustainability, Nyema hopes her work will plant seeds in the minds and imaginations of her peers and younger people in the city. 
“People need to see us doing it,” she says “People need to be able to see themselves engaging in this practice.”
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Gennette Cordova is a writer and organizer currently based in Brooklyn. Originally from Seattle, she has written many times about the struggles and successes of Black women.

Gennette Cordova

Growing Community through Community Farming

Among the many strategies for staying healthy is paying attention to your digestive system.
23andMe adds a new report for 23andMe+ Premium members on diverticulitis, a common but not well-known condition that affects the gut.  
Diverticulitis occurs at weak spots in the intestinal tract, where small bulging pouches become inflamed. These pouches, most often found in the large intestine (also called the colon), are called “diverticula.” They are common, especially as we age, but usually do not cause problems.
<img loading="lazy" decoding="async" class="alignright wp-image-29498 size-medium" src="https://blog-api.23andme.com/wp-content/uploads/2022/02/Screen-Shot-2022-02-10-at-2.23.06-PM-289x300.png" alt="" width="289" height="300" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/02/Screen-Shot-2022-02-10-at-2.23.06-PM-289x300.png 289w, https://blogcms.23andme.com/wp-content/uploads/2022/02/Screen-Shot-2022-02-10-at-2.23.06-PM.png 576w" sizes="auto, (max-width: 289px) 100vw, 289px" />It’s estimated that more than half of people in the United States over 60 have diverticula, and most likely never have any issues. But about five percent of those individuals will develop inflammation in these pouches, a condition called “diverticulitis,” according to the<a href="https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/definition-facts"> National Institutes of Health.</a> This can lead to symptoms such as abdominal pain, vomiting, fever, constipation, or diarrhea. More serious complications, such as blockages or perforations, can lead to hospitalization.
Genetics, diet, a lack of exercise, being overweight, and some medications can all contribute to one’s chances of developing the condition.
<h6>23andMe+ PREMIUM</h6>
As part of 23andMe+ Premium, members can now access a Diverticulitis report powered by 23andMe research data.
The new report uses machine learning techniques to estimate a person’s likelihood of developing diverticulitis. In the report, we make the estimate with a statistical model that uses data from 23andMe research participants and includes more than 5,000 genetic variants. The report also takes into account a person’s ethnicity and birth sex.
<h6>Taking Action</h6>
Fortunately, one can lower their chances of developing diverticulitis with a healthy lifestyle. That includes eating more fiber and less red meat, maintaining a healthy weight, and exercising regularly.
Taking steps to learn about your genetics and your family medical history, and talking with your healthcare provider will help you understand your own chances and the right steps for prevention.
<h6>More</h6>
23andMe’s new Diverticulitis report (powered by 23andMe research) is available to all members that join the 23andMe+ Premium membership. To learn more about your report, members can go<a href="https://you.23andme.com/reports/prs.diverticulitis/"> here</a>.
Haven’t joined the 23andMe+ Premium membership yet?
 Find out more<a href="https://www.23andme.com/membership/?ban=stky"> here</a>.

23andMe Blog

23andMe Blog Team

23andMe+ Premium Report on Diverticulitis

Why are people attracted to specific traits in romantic partners? How can someone garnish all their dishes with cilantro and someone else recoil at the thought? What makes an individual reach for sweet snacks instead of salty ones?
&nbsp;The mystery behind why we love what we love has fascinated humanity for millennia.
But even love – that intangible emotion long contemplated by philosophers, artists, poets, and head-over-heels teenagers – is not impervious to the reach of DNA. In fact, research shows that genetics can influence our preferences and tastes.

<h6>Birds of a Feather</h6>
It turns out there might be some scientific proof to the adage “birds of a feather flock together,” at least when it comes to mate preference.
A study published in<a href="https://www.nature.com/articles/s41562-016-0016"> Nature Human Behavior</a> identified genetic evidence for assortative mating, defined as the tendency to select and mate with partners who are similar to us.
&nbsp;Researchers at the University of Queensland, the University of North Carolina, 23andMe, and other institutions, looked at two specific traits in couples: height and body mass index (BMI).&nbsp;&nbsp;
They used data from more than 24,000 couples, including 11,908 consenting couples from 23andMe, and compared an individual’s genetically predicted height and BMI to those of their partner.
The study<a href="https://blog.23andme.com/23andme-research/you-complete-me/"> found</a> a strong correlation between people’s genetic predisposition for height and their partner’s actual height. A weaker but still statistically significant correlation was also found between people’s genes for BMI and the actual BMI of their partners.

<h6>Pass the Salt… or the Sugar</h6>
Picture your perfect snack. Is it sweet – a bowl of ice cream, or maybe a cookie? Or is it salty (think: popcorn or chips)?
Genetics may influence your choice by impacting how your brain identifies and responds to tastes.
&nbsp;It all starts with a single bite. When food enters your mouth, your taste buds get to work – sending signals to two different brain areas. These regions help you identify and decide if you like a flavor.
Scientists from 23andMe have <a href="https://www.23andme.com/topics/traits/sweet-salty">identified</a> 43 genetic markers associated with a preference for salty or sweet foods.&nbsp;
&nbsp;Several of these markers are found near genes involved in brain development and function. And two are located in genes associated with food metabolism and body mass, including the FTO gene, which has been linked to obesity.

<h6>The Great Cilantro Divide</h6>
Add cilantro (also known as coriander) to the list of topics you shouldn’t bring up at the dinner table. Like politics and religion, this green, leafy herb elicits surprisingly strong reactions. Some hate it and swear it tastes like soap. Others love it and can’t imagine a dish without it.&nbsp;
What makes this herb so polarizing? Genetics offers a clue. 23andMe researchers<a href="https://blog.23andme.com/23andme-research/cilantro-love-hate-genetic-trait/"> found</a> two genetic markers associated with cilantro aversion located near a cluster of olfactory receptor genes. Some of these receptors help us perceive aldehydes, chemical compounds that contribute to cilantro’s “soapy” scent.
Culture and environment can also influence cilantro preference. According to a 23andMe <a href="https://flavourjournal.biomedcentral.com/articles/10.1186/2044-7248-1-8">study</a>, only 3-7 percent of those who identify as South Asian, Latino, or Middle Eastern dislike the herb compared to 14-21 percent of people of East Asian, African, or European ancestry.&nbsp;
Researchers posit that this difference could be partially due to the ubiquity of cilantro in various regional cuisines, which results in frequent exposure to the herb.

In light of these research findings, perhaps we can offer an addition to this well-known quote by the Sufi mystic and poet Rumi: “Only Love… [and DNA] can explain the mysteries of Love.”
Happy Valentine’s Day!

Love, Decoded

By Adam Auton, 23andMe Vice President, Human Genetics
For scientists at 23andMe, the recent announcement of taking our <a href="https://investors.23andme.com/news-releases/news-release-details/23andme-initiates-phase-1-clinical-trial-first-wholly-owned">first wholly-owned cancer drug</a> into a clinical trial is beyond exciting. This is a huge milestone for the company and for our Therapeutics group. 
As a scientist and vice president for human genetics at 23andMe, I would love for more people to understand how important this is; not just for us at 23andMe, but also as a demonstration of how genetic research is transforming drug discovery.
So, I&#8217;m writing this post to explain how our unique database shapes our approach to drug target discovery. The intent is to share more about how we use both genetic information and non-genetic information together in the largest database of its kind. We are generating insights backed by human genetics at an unprecedented scale so that more people can benefit from what we learn about the human genome.
The two things to know is that at 23andMe, it all begins with human genetics, but it doesn&#8217;t end there. 
But before diving into that, let’s take a detour using a real-world example to explain a bit about 23andMe’s unique research model and how it sets us apart.
<h6>The 23andMe COVID-19 Study </h6>
23andMe isn&#8217;t developing vaccines or therapies for COVID-19, so what does that have to do with this topic? Put simply, what we were able to do as scientists studying COVID-19 is a beautiful illustration of the power of our research model. Let me explain.
Early in the pandemic, the scientists at 23andMe, like scientists around the world, asked ourselves, &#8220;what can we do to help?&#8221; 
23andMe has a very, very large database of re-contactable customers who have consented to participate in our research. That gives us the power to study all manner of diseases, including COVID-19. 
We were curious whether there was something we could learn about the disease that could reveal more about its biological mechanisms and offer insights about potential ways to treat it. Specifically, we wanted to understand why some people get very sick with COVID-19, whereas others experience an asymptomatic infection. Why is this? Could genetics play a role?
We set up our <a href="https://you.23andme.com/covid19-study/">COVID-19 Study</a> and asked our research participants questions about their experience with the virus. In a matter of a few months, we had more than 1.2 million people participating in our study and we were able to generate a host of findings. 
We found that <a href="https://blog.23andme.com/23andme-research/blood-type-and-covid-19/">blood type</a> plays a role in the susceptibility to the virus and a locus on chromosome 3 appears to influence severity in symptoms among those who get it. And we found genetic associations with the loss of <a href="https://blog.23andme.com/23andme-research/loss-of-smell-covid-study/">smell and taste</a> among those with the virus. 
Additionally, we investigated differences in <a href="https://blog.23andme.com/23andme-research/covid-19-vaccine-reactions/">vaccine reactions</a> among people. We also have some of the largest cohorts of underrepresented populations, which allowed us to discern some of the different impacts the virus has had on people of <a href="https://blog.23andme.com/23andme-research/impact-disparities-of-covid-19/">different ethnicities</a>. And we were able to share these findings with the scientific community, our customers, and the public at large as soon as we made them. 
This is a great example of science in action. Recruiting and surveying large numbers of individuals regarding their experiences with a specific disease would usually take years. In this case, we were able to go from a scientific idea to a collection of results in a matter of weeks or months.
That&#8217;s the power of what we can do with our large-scale research platform that includes millions of people from diverse backgrounds who have consented to participate in research. 
This relates to drug discovery in that it demonstrates the power of our research engine to discern important and relevant genetic associations quickly. But, of course, there are a number of steps and a lot more work that needs to happen after making those initial findings. 

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="914" height="1024" src="https://blogcms.23andme.com/wp-content/uploads/2022/02/COVID-Study-Graphic-914x1024.jpg" alt="" class="wp-image-29489" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/02/COVID-Study-Graphic-914x1024.jpg 914w, https://blogcms.23andme.com/wp-content/uploads/2022/02/COVID-Study-Graphic-268x300.jpg 268w, https://blogcms.23andme.com/wp-content/uploads/2022/02/COVID-Study-Graphic-768x861.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2022/02/COVID-Study-Graphic-785x880.jpg 785w, https://blogcms.23andme.com/wp-content/uploads/2022/02/COVID-Study-Graphic.jpg 1026w" sizes="auto, (max-width: 914px) 100vw, 914px" /></figure>
 
<h6></h6>
<h6>23andMe Therapeutics</h6>
Traditional drug discovery and development is incredibly inefficient and expensive. Developing a drug is difficult. On average, it can cost <a href="https://jamanetwork.com/journals/jama/article-abstract/2762311">about $1 billion</a> according to some estimates and can take more than a decade. And the failure rate for new drug development is more than <a href="https://www.nature.com/articles/s41598-019-54849-w">90 percen</a>t.
But suppose you start that process with evidence that a naturally occurring genetic variant within your target gene is associated with a particular disease. Studies have shown that the chances of successfully developing a drug against that gene are significantly increased, perhaps by a factor of two. Given this type of evidence, you can focus on targets that have the most promise for success and thereby accelerate the pace of developing a drug. In an industry where just one in ten drugs makes it to patients, the potential impact on transforming this expensive and time-consuming process is enormous. 
To find genetic associations relevant to targets, large datasets are important. As approximately 80% of 23andMe customers consent to participate in research, 23andMe has a large enough database to identify many genetic associations across thousands of diseases. In addition, people who consent to participate in our research can remain engaged, allowing our scientists to ask additional questions over time. This can, for instance, allow us to study the progression of different health conditions. Or, if our scientists are interested in better understanding a specific disease condition, we can go back and re-contact people to ask for more detail with regard to that condition, which can further help us understand how genetic variants are causing that specific disease condition.
All this data helps us improve the kind of information we can give back to customers, but it also powers new genetic insights, and over time we hope it will lead to the development of new therapies for people who need them most.
There really isn&#8217;t anything like it right now. 

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="528" src="https://blogcms.23andme.com/wp-content/uploads/2022/02/Flywheel-1024x528.jpg" alt="" class="wp-image-29490" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/02/Flywheel-1024x528.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/02/Flywheel-300x155.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2022/02/Flywheel-768x396.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2022/02/Flywheel-880x454.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2022/02/Flywheel-1180x609.jpg 1180w, https://blogcms.23andme.com/wp-content/uploads/2022/02/Flywheel.jpg 2036w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6></h6>
<h6>Drug Discovery</h6>
Our research data covers more than 1,000 different conditions.
This gives our scientists a unique opportunity to think about how genetics can reshape the translational science needed to move a potential target into the clinic.
Along with using genetic associations to discover new drug targets, we can also use genetics to understand the best path for a target into the clinic. Specifically, we might see a given target has genetic associations with multiple diseases, and we can use that information to decide where the target might be most beneficial for patients. This information might also allow us to see if a potential drug target is more likely to have serious side effects, in which case we could decide to move on from that target.  
Combining the genetic data with multiple types of phenotypic data gives us a much deeper understanding of each specific gene and the underlying biology, allowing us to really focus our efforts on the targets with the highest chances of successfully becoming a drug. 
Of course, having a genetic association is still a very long way from having a drug! There is a tremendous amount of work to do, and a lot of questions to answer. Even if we find an association, is it in or regulating a gene that we suspect plays a role in the biological mechanism of that disease? Are there experiments we can do to confirm our suspicions? Can the gene in question actually be drugged? Are other groups already working on this gene? What is the unmet medical need in this disease, and do we think drugging this gene would be better than the existing standard of care? We need to answer all of these questions (and many, many more), but by starting with what we believe is the greatest genetic database in the world, we hope that we are able to bring the best opportunities forward in order to help patients in need as quickly as possible. 
<h6>My Background</h6>
I came to 23andMe about seven years ago, just as we formed the Therapeutics division. Previously I was an Assistant Professor of Genetics at Albert Einstein College of Medicine in New York City, where I worked on large-scale genetic analyses looking to understand the genetic underpinnings of human disease. 
When I joined 23andMe, the database was much smaller, but it was clear that the potential was there. Since then, 23andMe has grown such that instead of seeing handfuls of genetic associations for different diseases, we are now seeing many thousands. Seeing this growth has been tremendously exciting.
This enormous database has allowed us to start more than 40 programs — many of which in collaboration with GSK — to develop targets to potentially treat conditions in oncology, immunology, respiratory and cardiometabolic disease.
What is game-changing about what 23andMe is doing is that we can make novel insights that simply aren’t available anywhere else. It is rewarding to see one of those insights lead to the development of a drug in a phase 1 clinical trial.
 

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="680" height="1024" src="https://blogcms.23andme.com/wp-content/uploads/2017/09/©Piter2016-23andMe-AdamAuton-066-680x1024.jpg" alt="" class="wp-image-25740" srcset="https://blogcms.23andme.com/wp-content/uploads/2017/09/©Piter2016-23andMe-AdamAuton-066-680x1024.jpg 680w, https://blogcms.23andme.com/wp-content/uploads/2017/09/©Piter2016-23andMe-AdamAuton-066-199x300.jpg 199w, https://blogcms.23andme.com/wp-content/uploads/2017/09/©Piter2016-23andMe-AdamAuton-066-768x1156.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2017/09/©Piter2016-23andMe-AdamAuton-066-585x880.jpg 585w, https://blogcms.23andme.com/wp-content/uploads/2017/09/©Piter2016-23andMe-AdamAuton-066-784x1180.jpg 784w, https://blogcms.23andme.com/wp-content/uploads/2017/09/©Piter2016-23andMe-AdamAuton-066-scaled.jpg 1701w" sizes="auto, (max-width: 680px) 100vw, 680px" /></figure>
 
<hr />
Adam Auton is the Vice President of Human Genetics at 23andMe and is responsible for computational approaches to target discovery via statistical genetics and computational biology. Before joining 23andMe, Adam was an assistant professor at Albert Einstein College of Medicine, where his group developed algorithmic approaches for using large-scale genomic data to understand human population genetics. Adam earned his DPhil in statistics from Oxford University, before completing his post-doctoral training at the Wellcome Trust Centre for Human Genetics at Oxford, and Cornell University.

23andMe’s Drug Discovery Process Explained

If there’s a sweet spot between discovery and medicine — between answering the big scientific questions of the day, and administering the small but personal care required of the best physicians — then John Matthews is there.<img loading="lazy" decoding="async" src="https://blog-api.23andme.com/wp-content/uploads/2022/02/HUmans_23andME_me-1-36-1-576x1024.jpg" alt="" width="400" height="711" class="alignright wp-image-29473" />
That has a lot to do with his unique background and experience.
 Born in Malawi to a dad who was an agricultural scientist with a Ph.D., and a mom who worked as a hospital nurse, John grew up curious about both science and medicine. (His parents met in Rhodesia while John’s father was flying in a helicopter over farms and spotted his future wife in a red dress having a picnic among the white of a cotton field.) One of John’s uncles was also a doctor, and John developed a natural affinity toward helping people, even performing first aid on the playground in grade school.
“I learned various solutions to deal with simple problems like how to manage nettle stings or remove grit from the eye, washing grazed knees, bee stings, etc.,” he said. “I was very curious about how the body worked, and why it didn’t.”
Now the senior clinical development fellow on 23andMe’s Therapeutics team, John is still wrestling with those questions. He is both a physician who trained in pulmonary medicine and a scientist with a Ph.D. from the National Heart and Lung Institute at Imperial College in the UK. He worked directly with patients in an intensive care unit at a hospital in London, and after leaving clinical practice he spent years working at companies developing medicines meant to treat people with the kind of serious illness he often attended to on the ward.
And he still draws on his early years as a doctor for inspiration. John points to a handful of patients who he said fundamentally changed him and continue to motivate him. One, in particular, was a dying man with HIV who struggled simply to swallow food. Although there were new anti-retroviral treatments, those treatments didn’t become widely available for patients for another ten years. And those lifesaving drugs weren’t available to help this patient. For John, who cared for this patient as he died, it cemented the need to develop medicines faster.
“It was hard to be in a situation where novel therapeutics were so desperately needed and this patient is a constant reminder of the urgency to find new medicines for severe unmet needs,” John said. 
That’s a central mission for <a href="https://www.23andme.com/therapeutics/">23andMe’s Therapeutics</a> efforts and part of what drew John to work here.
On a day-to-day basis, John focuses on refining 23andMe drug discovery. Some of that involves developing plans for good clinical practice for such things as safety and data management. But he also brings understanding from those early days on the ward caring for people who were sick or dying. He has been instrumental in 23andMe’s efforts studying rare diseases for instance and explaining the science to patient advocacy groups.
We sat down with John to talk about his career, why he came to 23andMe, and what drives him as a scientist and physician.
<h6>You were born in Malawi, can you tell us a little bit about that, and about where you grew up?</h6>
John: “My parents were living in Malawi — Dad started working as an entomologist at Imperial College, in 1967 and through a UK government grant was based in the newly independent country Malawi to study cotton pests. Mum was working for a hospital as a nurse and Dad was doing his Ph.D. 
We left when I was almost five. But I went back just before I qualified as a doctor, visiting Zimbabwe and Malawi, working on a project comparing asthma in urban and rural areas. 
I visited the Makoka research station and the house I grew up in. I trekked out to the countryside and with various guides and contacts found the man who had taken care of me as a child. I went back daily for a few days buying fertilizer and new wellington boots for him — feeling guilty the whole time. He can’t speak English but he had a photo of me in his kitchen. I feel bad that (our family) didn’t do enough for him. My effort now is to regularly fund Kiva loans for Malawians (<a href="http://www.kiva.org">www.kiva.org</a>) and support various efforts in Malawi  — but it always feels like a drop in the ocean.”  
<h6>You trained in medicine and practiced for a while. Why did you go into medicine?</h6>
John: “My mum was a nurse and my uncle Seamus was a pathologist in Dublin. Between my mum and my uncle “medicine” was referred to a lot. I grew up knowing that medicine was a responsibility to care for anyone in need. When I was at school (aged 7-to-10) kids used to come to me in the playground with injuries – and I learned various solutions to deal with simple problems – like how to manage nettle stings or remove grit from the eye, washing grazed knees, bee stings, etc. I was very curious about how the body worked and why it didn’t.”
<h6>You’ve said before that you’re interested in physiology, body metabolism, and aging. Why is that?</h6>
John: &#8220;I did an extra year at medical school to study physiology. I wanted to go deeper into science. Physiology seemed to be the best way to actually look into how the body worked and it seemed a lot more fun than learning more anatomy or biochemistry. The physiology faculty at my medical school were always the best lecturers. The experiments to make discoveries were also more accessible than imagining what was happening in a chemical reaction. I even took part in <a href="https://pubmed.ncbi.nlm.nih.gov/1400059/">human physiology experiments</a> as a subject. 
I was encouraged to study areas with little scientific consensus, such as the control mechanisms of the exercise ventilatory response. I worked in an intensive care unit in London called the Mead ward. It was set up by Professor Ron Bradley, the first full-time intensive care clinician in the UK. He also ran the ICU at St Thomas’ Hospital, London. When I was on the ward, Ron, who had retired, still came in every week to give us tutorials. He had developed a way to estimate cardiac output through his work deriving simple equations that he had developed with quantitative data from human experiments. 
Without going into too much detail, the takeaway for me was that a close physical examination of the patient can give quantitative data on the circulatory state of the patient. The challenge is the ability to capture clinical information and lump or split patients in ways that can help us get to a molecular understanding of disease. 23andMe has pioneered capturing self-report data from the patient, but we haven’t yet mastered capturing the reports of the doctors and nurses that look after them.” 
<h6>What are your hopes for the work you are doing?</h6>
John: “My hope is to see our work yield significant new medicines in the shortest time frame possible.
I’m also very interested in what 23andMe can do around rare diseases. I hope we can communicate the potential of 23andMe to make genetic findings for a large number of rare diseases for which there is very little known currently. 
We’ve recently finished <a href="https://www.medrxiv.org/content/10.1101/2021.06.09.21258643v1">a paper</a> illustrating that potential. There are more than 7,000 rare diseases. Being able to find a genetic basis for some of these conditions could offer valuable insights into diagnosis and treatment. We have the potential to do that for many conditions if we are able to find enough individuals with these conditions to participate in our research.”  
&nbsp;

Patients Inspire Therapeutics Scientist

Editor&#8217;s note: Since we last posted this we&#8217;ve added two new health reports and so we&#8217;ve updated this post for Heart Health Month 2022.&nbsp;
February is American Heart Month: a time to learn about heart disease and healthy lifestyle actions you can take to prevent it.
Heart disease is responsible for over 600,000 deaths in the U.S. each year making it the <a href="https://www.cdc.gov/heartdisease/facts.htm">leading (non-pandemic) cause of death in the U.S</a>. Heart disease includes a number of different conditions that relate to your heart&#8217;s rhythm, muscle, and blood vessels. Luckily there are things we can all do to lower our risk for, or even prevent heart disease. Learning about what your genetics can tell you about your heart, can be a good first step.
<h6>Explore Heart Health</h6>
23andMe Health + Ancestry Service offers a number of reports* on heart-related conditions to explore:
<ul>
<li aria-level="1">Familial hypercholesterolemia (FH) is a genetic condition associated with very high levels of cholesterol in the blood, specifically low-density lipoprotein (LDL), or &#8220;bad&#8221; cholesterol. High cholesterol due to FH increases the risk for early cardiovascular disease, which can lead to a heart attack.</li>
</ul>
<ul>
<li aria-level="1">TTR-related hereditary amyloidosis is a genetic condition caused by the buildup of a protein called transthyretin in the body&#8217;s tissues and organs. This protein buildup, called amyloidosis, can damage different parts of the body including the heart, which can lead to heart failure.</li>
</ul>
<ul>
<li aria-level="1">Type 2 diabetes: In type 2 diabetes, sugar builds up in the blood, which over time can lead to complications like heart disease and stroke. This report is powered by 23andMe Research and can tell you about your genetic chances of developing this condition.</li>
</ul>

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="545" height="1024" src="https://blogcms.23andme.com/wp-content/uploads/2020/09/Heart-Health-Intro-1-1-545x1024.png" alt="" class="wp-image-28529" srcset="https://blogcms.23andme.com/wp-content/uploads/2020/09/Heart-Health-Intro-1-1-545x1024.png 545w, https://blogcms.23andme.com/wp-content/uploads/2020/09/Heart-Health-Intro-1-1-160x300.png 160w, https://blogcms.23andme.com/wp-content/uploads/2020/09/Heart-Health-Intro-1-1-768x1444.png 768w, https://blogcms.23andme.com/wp-content/uploads/2020/09/Heart-Health-Intro-1-1-468x880.png 468w, https://blogcms.23andme.com/wp-content/uploads/2020/09/Heart-Health-Intro-1-1-628x1180.png 628w, https://blogcms.23andme.com/wp-content/uploads/2020/09/Heart-Health-Intro-1-1.png 982w" sizes="auto, (max-width: 545px) 100vw, 545px" /></figure>
 
<h6>Looking to Go Deeper</h6>
For those who want to explore, even more, we offer 23andMe+, an annual membership with 10+ exclusive reports and features delivered to you throughout the year. Some of those exclusive reports, powered by 23andMe Research, include heart-related conditions to explore:
<ul>
<li aria-level="1">Atrial fibrillation is a common type of irregular heartbeat. It occurs when the two upper chambers of the heartbeat irregularly. People with atrial fibrillation have a higher risk for blood clots, stroke, and heart failure.</li>
</ul>
<ul>
<li aria-level="1">Coronary artery disease is a type of heart disease that is typically caused by the buildup of a waxy, cholesterol-containing substance called plaque inside the coronary arteries, which are the major blood vessels that supply the heart with oxygen-rich blood. When plaque builds up in the coronary arteries, the vessels narrow, and blood flow to the heart is decreased.</li>
</ul>
<ul>
<li aria-level="1">High blood pressure, also called hypertension, is when the blood puts too much pressure on the walls of blood vessels, which can lead to heart disease, stroke, and other health problems.</li>
</ul>
<ul>
<li aria-level="1">HDL cholesterol, &nbsp;the so-called “good cholesterol,” higher levels of high-density lipoprotein, HDL, are &nbsp;associated with a lower risk for heart disease. That’s because HDL acts like an arterial cleanser, removing cholesterol from blood vessels and taking it back to the liver for its removal from the body. This helps prevent LDL cholesterol from building up on the walls of blood vessels and restricting blood flow.</li>
</ul>
<ul>
<li aria-level="1">LDL cholesterol, or “bad cholesterol” can increase your risk for heart attack or stroke. This report can tell customers who don&#8217;t have a genetic variant detected in their Familial Hypercholesterolemia Genetic Health Risk report, about their chances of having high levels of &#8220;bad&#8221; cholesterol.</li>
</ul>
<ul>
<li aria-level="1">Triglycerides — a type of fat, or lipid, that the body uses to store energy from food for future use. High triglyceride levels are associated with an increased likelihood of developing heart disease, stroke, and sometimes pancreatitis.</li>
</ul>
Learning more about your genetics can help by raising your awareness of certain heart-related conditions. But it&#8217;s also important to keep in mind that things like your family history, ethnicity, and age can also affect your chances of developing these conditions.
Knowing about your genetics isn&#8217;t the end. Taking healthy actions to lower blood pressure, cholesterol and blood sugar can help lower your risk for heart disease. For many heart-related conditions, your everyday actions play a big role in your overall chances of developing (or developing serious complications from) the condition. Maintaining a healthy weight, getting regular exercise, and eating a heart-healthy diet are some of the recommended ways to keep our hearts healthy. This American Heart Month, think about any new actions you can take to keep your heart beating its best.
<hr>
*23andMe health predisposition reports include both reports that meet FDA requirements for genetic health risks and reports which are based on 23andMe research and have not been reviewed by the FDA. The test uses qualitative genotyping to detect select clinically relevant variants in the genomic DNA of adults from saliva for the purpose of reporting and interpreting genetic health risks. It is not intended to diagnose any disease. Your ethnicity may affect the relevance of each report and how your genetic health risk results are interpreted. Each genetic health risk report describes if a person has variants associated with a higher risk of developing a disease, but does not describe a person’s overall risk of developing the disease. The test is not intended to tell you anything about your current state of health, or to be used to make medical decisions, including whether or not you should take a medication, how much of a medication you should take, or determine any treatment. For important information and limitations regarding each genetic health risk report, visit 23andme.com/test-info/.

Take Action for Heart Health

By Melinda King, 23andMe&#8217;s Director of Diversity, Equity &amp; Inclusion 
Black History Month is meant to celebrate our contributions and acknowledge how far we&#8217;ve come, but for me, all that has happened in the last two years only reminds me how far we still have to go. 
I will never be able to think of this time without being reminded of the murder of George Floyd.   
As a Black woman, a mother of two sons, his brutal murder at the hands of a Minneapolis police officer shook me. It led me to move across the country for a new job and double down on my commitment to change the world where a Black man could have the life choked out of him under the color of law. 
<h6>Addressing Inequality and Injustice</h6>
I thought perhaps it also would be a moment that genuinely shook our country from its indifference to structural racism. But, a year and a half on, I’m not so sure. I fear the momentum to change is wafting away. I feel that is especially true here in Silicon Valley where so many companies make public commitments to take action to address racial inequality and injustice.
My job, the thing I get paid to do, is in part to remind, cajole and argue for inclusion in the workplace. I’m doing this work in Silicon Valley, which has its own diversity problem. There is a lot to be encouraged by but even with espoused commitments to change, it can be a lonely job. Even as I walk the streets of San Jose, I am constantly reminded of who I am and who I’m not. I’m reminded when I walk outside of my overpriced new apartment building only to be asked by the white woman crossing the street with me if it’s a low-income building. That’s because there is sometimes a disconnect between people who see and are shocked by the deaths of George Floyd, or <a href="https://www.runnersworld.com/runners-stories/a32883923/ahmaud-arbery-death-running-and-racism/">Ahmaud Arbery</a>, or <a href="https://www.nytimes.com/article/breonna-taylor-police.html">Breonna Taylor</a>, but can’t see what’s right in front of them. They can’t see how what caused those deaths connects to the structural racism that has excluded people like George or Ahmaud or Breonna, from the broader opportunities of our society. They struggle to connect all the dots that lead to Black people being in life or death situations regularly. 
<h6>The Potential for Positive Change</h6>
That’s why I came here. It’s because Silicon Valley is at the hub of innovation and opportunity.  Failing to embrace diversity here has both a moral and a business cost. We’ve witnessed the power of tech companies to profoundly transform society, both for the good and the bad. Fixing the diversity problem here could have an outsized and positive impact on the rest of the world. However, that requires real commitment. It requires making room for more diversity at the table and listening to those new voices. 
I am not naive to the complexity and history of race problems. I know what it means to be Black in America. I still remember sitting in a segregated doctor’s office as a little girl in rural Alabama. I remember having a hard conversation with my young son after someone called him the “n-word” in his grade school classroom.
<h6>It&#8217;s Everyone&#8217;s Job</h6>
But we don’t have to accept the way things are.
To quote<a href="https://www.nytimes.com/2008/02/05/us/politics/05text-obama.html"> President Barack Obama</a>, “Change will not come if we wait for some other person or some other time. We are the ones we&#8217;ve been waiting for. We are the change that we seek.”
Diversity, equity, and inclusion is my job, but it’s also your job. It’s everyone’s job. It requires each of us to be “the change we seek.”
It means more than words. It means actions. I say that even though it was words that brought me here. I heard the CEO and Co-Founder of 23andMe, Anne Wojcicki, <a href="https://www.23andme.com/black-lives-matter">call out her own company</a> for its failings on inclusion. She was willing to say her company, in the heart of Silicon Valley, was part of the problem. I reached out to her and asked if I could assist in making a change. That’s how I came to work at 23andMe.
Although it was Anne’s words that first drew me here, it’s my commitment to this community, the 23andMe employees, and this work that keeps me going. Since coming here we have brought diversity to our board, added new leaders, and continue to commit to adding more diversity to our organization. We continue to improve our product to make it more inclusive and have created employee groups to support people with different affinities, abilities, and ethnicities. 
<h6>Let&#8217;s Do More</h6>
But it’s not enough. There is so much more for us and other companies to do. We all have to do better. Leaders need to step outside their current network and develop relationships with people of different backgrounds. If you think that can’t happen, know that Black people have had to do that for generations in order to survive in corporate America. Challenge others when you see them sharing a narrative of “we are all the same.” While it’s a lovely sentiment, it’s not true. 
That brings me back to George Floyd, and my moment of clarity. It wasn’t that it reminded me of what I already know, it simply prompted me to focus on doing more to change the world that allows for something like that to happen. Tapping that resolve is what will help us keep our commitment, to do more than just talk about diversity, equity, and inclusion.
Let’s move away from all the things we say we will do and focus on actually doing the work that has an impact for the communities who have been left behind in the past.

Melinda King

The Change We Seek

23andMe researchers found that direct-to-consumer DNA testing can help identify individuals who are at risk for the hard-to-diagnose genetic condition alpha-1 antitrypsin deficiency (AATD), a condition that increases the risk of lung and liver disease.&nbsp;
In some cases, testing not only helped flag a risk for individuals who may not have known otherwise, it also helped instigate important conversations with their healthcare provider.&nbsp;
<h6>Large Study</h6>
Published in the journal <a href="https://journal.chestnet.org/article/S0012-3692(21)04099-X/fulltext">Chest</a>, the study is the largest to date to examine both the prevalence of AATD and the behavioral impact of learning that one carries a risk variant for the genetic condition. Another striking finding from the study was that one-quarter of those diagnosed with AATD were not diagnosed until after receiving their 23andMe Alpha-1 Antitrypsin (AAT) Deficiency Genetic Health Risk report.*
“This suggests that testing is helping to identify people who might otherwise slip through the cracks,” said James Ashenhurst, Ph.D., a senior scientist on 23andMe’s Health research and development team.
<h6>Hard to Diagnose</h6>
Getting treatment early can mitigate medical complications but many individuals with the condition are unaware they have it.
“Alpha-1 (AATD) is notoriously difficult to diagnose with the gap between the first symptoms and diagnosis estimated to be up to 10 years typically,” said Ashenhurst, who was also a lead author on the paper.
While it is an inherited condition, people often are unaware of family history for AATD, and that may be why they were not screened for it before learning they carried the genetic variant, according to the study.
<h6>Alerting People to their Risk</h6>
Independent of this study, 23andMe researchers went back and conducted qualitative research with some of the participants to get a richer understanding of the impact of the report. Participants in the study were anonymous to protect their privacy but many echoed the sentiment that but for the report they wouldn’t have known of their risk.
“(N)ormally people don&#8217;t find out that they have this … until they have really serious emphysema,” said one of the study participants. “[My pulmonologist] said, probably if I had not done [23andMe], 10 years down the road, he would have been seeing me with some really disabling disease… I&#8217;m really grateful that I found out about it, and that I can do something about it.”
<h6>Many of Those with AATD Don&#8217;t Know It</h6>
It’s believed that AATD affects an estimated <a href="https://www.alphanet.org/what-is-alpha-1/">120,000 Americans</a>. Unfortunately, only about six percent of those with AATD are correctly diagnosed because the symptoms resemble chronic obstructive pulmonary disease (COPD), or emphysema, and it often takes years.&nbsp;
Two genetic variants in the SERPINA1 gene — called PI*Z and PI*S — lead to more than 95 percent of all cases of AATD. Those variants can decrease the transport of protein alpha-1 antitrypsin enzyme from the liver to the lungs. The protein is sent through the blood to the lungs to help protect lung tissue. Low levels in the lungs can lead to damage. In contrast, abnormal levels of alpha-1 antitrypsin in the liver can cause damage to the liver. Symptoms may include shortness of breath, wheezing, or infections in the lungs or liver. Other symptoms might include yellow skin, fatigue, rapid heartbeat, vision problems, or weight loss.&nbsp;
Fortunately, there are treatments and therapies for AATD, but an early diagnosis can make a massive difference in the outcome.
Another participant in the unpublished qualitative research study told our researchers that even though she regularly experienced many of the symptoms for AATD, it wasn’t until she saw her 23andMe report and talked to her doctor about it that she was diagnosed.&nbsp;
“Every time I got a cold, it would go straight to pneumonia,” she said. “So when I did [23andMe] and [23andMe] identified a risk for [AATD] … all of a sudden a key unlocked. It was like this is what&#8217;s been going on, so I immediately booked an appointment with my doctor [and] brought it in.”
<h6>The Takeaway</h6>
The study published this week was combined with clinical follow-up over two years and included data from more than 195,000 individuals. More than 1,450 of whom were diagnosed with AATD. Because of the follow-up portion of the study, the researchers learned more about the impact the information had on those who knew of their risk through direct-to-consumer genetic testing.
Individuals with risk variants were considerably more likely to discuss the results with their health care providers and family, for instance. For some, this prompted family members to also get tested for AATD. In addition, the results also appeared to prompt individuals to make behavior changes to reduce their risk. Those with risk variants were more likely to report that they reduced smoking and alcohol consumption for instance.
“There’s a lot to take away from this study,” said Ashenhurst. “Beyond identifying people who might not have known of their risk otherwise, the study shows the impact this information has on people and their family. It appears to motivate them to take the kinds of actions you would want them to take to reduce their risk.”
23andMe Health and Ancestry Service customers can see their Alpha-1 Antitrypsin (AAT) Deficiency Genetic Health Risk report <a href="https://you.23andme.com/reports/ghr.aatd/">here</a>.
Not yet a customer? You can find out more about AATD <a href="https://www.23andme.com/topics/health-predispositions/alpha-1-antitrypsin-deficiency">here</a>, or go <a href="https://www.23andme.com/dna-health-ancestry">here</a> to learn more about 23andMe.
Read Claudia&#8217;s AATD story <a href="https://blog.23andme.com/health-traits/a-medical-mystery-solved/">here</a>.
<hr>
*The 23andMe PGS test uses qualitative genotyping to detect select clinically relevant variants in the genomic DNA of adults from saliva for the purpose of reporting and interpreting genetic health risks. It is not intended to diagnose any disease. Your ethnicity may affect the relevance of each report and how your genetic health risk results are interpreted. Each genetic health risk report describes if a person has variants associated with a higher risk of developing a disease, but does not describe a person’s overall risk of developing the disease. The test is not intended to tell you anything about your current state of health, or to be used to make medical decisions, including whether or not you should take a medication, how much of a medication you should take, or determine any treatment. &nbsp;The Alpha-1 Antitrypsin (AAT) Deficiency genetic health risk report is indicated for reporting of the PI*Z and PI*S variants in the SERPINA1 gene and describes if a person has variants associated with AAT deficiency and a higher risk for lung and liver disease. The variants included in this report are most common and best studied in people of European descent.

AATD Study

Skin cancer is the <a href="https://linkinghub.elsevier.com/retrieve/pii/S0749379714005108">most common</a> form of cancer, but it&#8217;s also one of the most preventable. 
Fortunately, knowing your risk along with protecting your skin from the sun can lower your chances of developing all three common forms. Early detection — often through self-exam and mole checks — can also go a long way toward ensuring healthy outcomes. 
In the U.S. alone, an estimated 3.3 million people are diagnosed with basal cell or squamous cell cancers each year, according to the American Cancer Society. Melanoma makes up a small percentage of all skin cancers, but it is the most lethal, contributing to the vast majority of skin cancer-related deaths, according to statistics from the <a href="https://www.cdc.gov/cancer/uscs/about/data-briefs/no9-melanoma-incidence-mortality-UnitedStates-2012-2016.htm">Centers for Disease Control and Prevention</a>.
<h6>23andMe+</h6>
As part of 23andMe+, members can now access two reports on these three common forms of skin cancer. These include a Skin Cancer (Melanoma) report, and a Skin Cancer (Basal and Squamous Cell Carcinomas) report. Both are powered by 23andMe Research.
The new reports use machine learning techniques to estimate a person&#8217;s likelihood of developing one of these forms of skin cancer. In the report on Skin Cancer (Basal and Squamous Cell Carcinomas), we make the estimate by using a statistical model that includes more than 11,000 genetic variants into account. For the report on Skin Cancer (Melanoma), the statistical model includes more than 1,800 genetic variants. The reports also take into account a person&#8217;s ethnicity and birth sex.
<h6>Skin Cancer Risk and Ethnicity</h6>
Because these types of skin cancers are so rare among certain ethnicities, we cannot provide genetic results for everyone at this time. In the cases of people of East and Southeast and South Asian descent, the likelihood of developing one of these cancers is so small that statistical models predicting these likelihoods based on genetics do not meet our scientific standards.
These models include customers’ results for thousands of genetic markers and are available for people of European, Latino, Northern African, Central and Western Asian as well as Sub-Saharan African descent. So, in the report on basal and squamous cell carcinomas, we are unable to provide a genetic likelihood for people of East and Southeast Asian and South Asian descent. In addition, in the report on melanoma, we are unable to provide a genetic likelihood for people of East Asian, Southeast Asian, South Asian, and African descent.  
While skin cancer can develop in people of all ethnicities, people of European descent have a much higher risk. The lifetime risk for melanoma is about two percent for people of European descent, but only about .1 percent among those of African descent. For people of Latino or Hispanic descent, it&#8217;s a little more than half a percent. But for people with darker skin, diagnosing melanoma often happens much later, resulting in potentially worse outcomes. In addition, people with darker skin are much more likely to develop melanoma in locations that get less sun, such as the palms of the hands, soles of the feet, beneath the fingernails, or even inside the mouth.
That&#8217;s what makes both prevention and skin self-exam so important. Experts recommend knowing the <a href="https://www.aad.org/public/diseases/skin-cancer/find/at-risk/abcdes">ABCDEs of melanoma</a> and performing a skin self-exam about once a month. It&#8217;s important to keep an eye on your skin and talk to a healthcare professional like a dermatologist if you notice any changes, including new or changed moles, bumps, or sores.
<h6>A Little Bit More About Skin Cancer</h6>
Basal and squamous cell carcinomas usually develop on areas of the skin that are more exposed to the sun, like the face and hands. The first sign might be a bump, growth, or a sore that doesn&#8217;t heal. For people with darker skin, these types of cancers often appear more like a dark brown or black bump that might be glossy and have a rolled border. Both are typically very treatable, tend to grow slowly, and often remain in the first layers of skin.
Melanomas are different and much more serious. While they can appear in much the same way, or develop from an existing mole, what happens below the skin&#8217;s surface is what makes them so dangerous.
That&#8217;s because melanomas are more likely than other skin cancers to spread locally or metastasize to other parts of the body. Again, this is why early detection is so important so that they can be treated before cancer can spread.
<h6>Research</h6>
In the case of skin cancer, we know that environmental factors, particularly sun exposure and repeated sunburns, increase the risk substantially. But research has found that genetic factors and specific traits also play a role.
23andMe has been involved in several research projects to create polygenic scores that would better estimate the likelihood of developing skin cancer. These <a href="https://blog.23andme.com/23andme-research/skin-cancer-risk-model/">statistical models</a> incorporate not just genetic variants but also family cancer history, skin pigmentation, sun exposure and body mass index, for instance. 
Not long ago, using data from consented 23andMe research participants, researchers from Indiana University found new genetic variants associated with <a href="https://blog.23andme.com/23andme-research/new-genetic-research-on-skin-cancer/">squamous cell carcinomas</a>. And a few years before, researchers at Stanford, also using 23andMe data, found new genetic variants associated with <a href="https://www.oncotarget.com/article/15230/">the risk of melanoma</a>. Most recently, a team of researchers in Australia, with the help of 23andMe data, found more than 70 genetic variants associated with melanoma and identified correlations between melanoma and <a href="https://www.jidonline.org/article/S0022-202X(21)02513-6/fulltext#secsectitle0070">autoimmune diseases</a> such as psoriasis and rheumatoid arthritis. 
<h6>Taking Action</h6>
Being vigilant especially for new moles or discolored skin, and protecting your skin from the sun, all can help lower the likelihood of developing skin cancer.
Self-exam is a little tougher for areas like your back so having a partner, your doctor, or a dermatologist take a look is a good idea.
Everyone should be aware of the risk for skin cancer,  but some individuals have more risk than others. Individuals with lighter-skin, or a lot of moles, or who sunburn easily, or who have a family history of skin cancer, should be particularly vigilant. 
Sun protection is important, but it&#8217;s also a good idea to avoid tanning beds. 
<h6>More</h6>
23andMe&#8217;s new skin cancer reports (powered by 23andMe research) are available to all annual subscribers to the 23andMe+ Membership.  To learn more about your report, go <a href="https://you.23andme.com/reports/prs.skin_cancer_melanoma/">here</a> and <a href="https://you.23andme.com/reports/prs.skin_cancer_bcc_scc/">here</a>. 
Not yet an annual subscriber to the 23andMe+ Membership?
Find out more <a href="https://www.23andme.com/membership">here</a>.

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