One of the tragedies of colorectal cancer is that although it is often preventable with screening and has a high survival rate when caught early, many are not getting screened, making colorectal cancer the second leading cause of cancer related deaths in the United States.



<figure class="wp-block-image aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="717" src="http://35.88.189.111/wp-content/uploads/2022/09/GettyImages-1251922051-1024x717.jpg" alt="Digital generated image of multi-ethnic arms raised in the air on dark gray background." class="wp-image-30161" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/09/GettyImages-1251922051-1024x717.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/09/GettyImages-1251922051-300x210.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2022/09/GettyImages-1251922051-768x538.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2022/09/GettyImages-1251922051-880x616.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2022/09/GettyImages-1251922051-1180x826.jpg 1180w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>



What’s more, colorectal cancer disproportionately impacts Black and African Americans, who tend to experience earlier onset and worse outcomes. Black and African American individuals have the second-highest mortality and incidence rates of colorectal cancer in the U.S. They are 35 percent more likely to die from colorectal cancer and 15 percent more likely to develop it than non-Hispanic whites, <a href="https://colorectalcancer.org/basics/facts-and-statistics">according to the Colorectal Cancer Alliance</a>.



<h2 class="wp-block-heading" id="h-the-collaboration">The Collaboration</h2>



A new collaboration between 23andMe and the non-profit Colorectal Cancer Alliance aims to raise awareness, encourage screening, and help people better understand their risks.&nbsp;



As part of 23andMe’s <a href="https://www.23andme.com/genetic-insights-into-colorectal-cancer-black-community/?utm[…]lfb&amp;utm_medium=social_organic&amp;utm_campaign=us_2024feb_crc_prs" target="_blank" rel="noreferrer noopener">Genetic Insights into Colorectal Cancer in the Black Community</a> study, we’re working with Colorectal Cancer Alliance to recruit Black and African Americans diagnosed with colorectal cancer as a way to improve polygenic risk scores used to flag heightened risk for colorectal cancer.



“We developed this study on colorectal cancer in the Black community to improve reports for Black and African Americans looking to learn more about their genetic likelihood of developing colorectal cancer,” said Anjali Shastri, Ph.D., principal program manager at 23andMe, Lead for diversity programs and advocacy partnerships for research. “We hope to develop and provide a genetic report to help the Black community learn more about their chances of developing this condition.”



Early detection and treatment offer the most hope for success for those with colorectal cancer, and screening can also help prevent cancers from developing. However, current polygenic risk scores for colorectal cancer perform poorly for Black and African American individuals. 23andMe, with the help of the Colorectal Cancer Alliance, hopes to pull in enough data from research participants to improve those risk models and provide meaningful reports for its Black and African American customers.  



Colorectal Cancer Alliance works toward increasing awareness about the importance of screening and removing the stigma around talking about colorectal cancer.



<h2 class="wp-block-heading" id="h-more-about-colorectal-cancer">More About Colorectal Cancer</h2>



Cancer occurs when abnormal cells divide and grow out of control. Colorectal cancer occurs in colon or rectum cells encompassing the large intestine. Most colorectal cancers start as a growth on the inner lining of the colon or rectum. These growths are called polyps.&nbsp;



Most polyps are not cancerous, but certain types can turn cancerous over time. With screening, colorectal cancer can be prevented by removing polyps before they have a chance to develop into cancer. While these typically are slow-growing, left untreated, these cancerous cells can spread beyond the colon or rectum through the blood and into the lymphatic system.&nbsp;



Like many forms of cancers, a complex mix of genetics, environment, age, diet, and lifestyle influence whether someone develops colorectal cancer. In a few types of hereditary conditions, such as <a href="https://www.cdc.gov/genomics/disease/colorectal_cancer/lynch.htm">Lynch syndrome</a> and <a href="https://blog.23andme.com/articles/23andmes-new-mutyh-report">MUTYH-associated polyposis</a>, genetics plays an outsized role. But such things as a diet low in fiber and high in fat, or that includes a lot of processed meats and not enough fruits and vegetables, or a lack of exercise, or simply being overweight can all contribute to a higher risk for colorectal cancer. A healthy diet, reducing alcohol consumption, stopping smoking, and maintaining a healthy weight can help lower one’s risk for the disease.



Current guidelines suggest routine <a href="https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html">screening at the age of 45</a>, but a family history of colorectal cancer or other risk factors may call for earlier screening.&nbsp;&nbsp;



The majority of colorectal cancers are diagnosed in people over the age of 50, and the overall rate of colorectal cancers has declined in the last few decades. However, a <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21772">recent study</a> by scientists with the American Cancer Society indicated that rates for those under the age of 55 have gone up. It’s become a leading cause of cancer-related death for men under 50 and second leading for women under 50. 



23andMe scientists are hoping to help change that by recruiting Black and African Americans in the United States who have been diagnosed with colorectal cancer and are willing to participate in our research.



<h2 class="wp-block-heading" id="h-23andme-s-colorectal-cancer-study">23andMe’s Colorectal Cancer Study</h2>



Like 23andMe has done with <a href="https://www.23andme.com/sarcoidosis-representation/">Sarcoidosis</a>, where the lack of diversity in genetic data prompted the company to recruit people from the Black and African American community, we are again reaching out to that community. However, this time, with the help of the Colorectal Cancer Alliance, all to improve the representation of colorectal cancer.



This research study is recruiting Black and African American individuals who are 18 years or older, live in the United States, and have been diagnosed with colorectal cancer. Individuals participating in this research study can access health reports through a 23andMe+ Premium membership at no cost. 



This new research study is part of our continued efforts to raise awareness about important health conditions that affect many individuals but disproportionately impact the Black and African American communities.&nbsp;



Questions? You can read Frequently Asked Questions here or contact us at crc-study@23andme.com. You can learn more about <a href="https://www.23andme.com/genetic-insights-into-colorectal-cancer-black-community/?utm[…]lfb&amp;utm_medium=social_organic&amp;utm_campaign=us_2024feb_crc_prs" target="_blank" rel="noreferrer noopener">Genetic Insights into Colorectal Cancer in the Black Community here.</a>

23andMe Blog

23andMe Blog Team

23andMe and Colorectal Cancer Alliance Team Up on Cancer Research

Summer is almost here, and along with all the sun and fun, it&#8217;s important to remember how best to protect your skin.&nbsp;



So, for Skin Cancer Awareness Month, we&#8217;re offering some helpful information and suggestions because skin cancer is the <a href="https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2024/2024-cancer-facts-and-figures-acs.pdf">most common</a> form of cancer; it&#8217;s also one of the most preventable.&nbsp;



<h2 class="wp-block-heading" id="h-skin-cancer-in-the-united-states">Skin Cancer in the United States</h2>



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 <a href="https://www.cancer.org/cancer/types/basal-and-squamous-cell-skin-cancer/about/key-statistics.html">American Cancer Society.</a> Melanoma makes up a small percentage of all skin cancers. Still, it is the most lethal, contributing to the vast majority of skin cancer-related deaths. These are three of the most common types of skin cancer.



Understanding your likelihood of developing one of these types of cancer and learning about what to look for goes a long way toward preventing them from developing. Sun exposure, either because you live in a sunnier climate or you spend a lot of time outdoors, plays a role.&nbsp;



We looked at where in the United States 23andMe customers who consented to participate in our research reported having been diagnosed with basal or squamous cell carcinomas.&nbsp;



<figure class="wp-block-image aligncenter size-full"><img loading="lazy" decoding="async" width="561" height="370" src="http://35.88.189.111/wp-content/uploads/2024/05/Percent-of-Customers-with-Either-BCC-or-SCC.jpg" alt="" class="wp-image-32916" srcset="https://blogcms.23andme.com/wp-content/uploads/2024/05/Percent-of-Customers-with-Either-BCC-or-SCC.jpg 561w, https://blogcms.23andme.com/wp-content/uploads/2024/05/Percent-of-Customers-with-Either-BCC-or-SCC-300x198.jpg 300w" sizes="auto, (max-width: 561px) 100vw, 561px" /></figure>



We do not have enough data to generate results for every state, but for the states we do have data, we see a higher prevalence of basal cell and squamous cancers in sunnier states. For instance, the highest prevalence is in Florida, Arizona, South Carolina, North Carolina, Alabama, and New Mexico. However, we also see a high prevalence in Delaware, which may be related to the age of the population there. The prevalence for both cancers increases with age, and Delaware has an aging population. We have not adjusted our data for age.



<h2 class="wp-block-heading" id="h-genetics-and-skin-cancer">Genetics and Skin Cancer</h2>



The likelihood of developing skin cancer is influenced not just by geography and sun exposure but also by a person&#8217;s ethnicity, lifestyle, and genetics. Skin cancer can develop in people of all ethnicities, but people of European descent with lighter skin tones have a much higher risk.&nbsp;



The lifetime risk for melanoma is about two percent for people of European descent but only about 0.1 percent among those of African descent. It&#8217;s a little more than half a percent for people of Latino or Hispanic descent.&nbsp;



<figure class="wp-block-image aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="538" src="http://35.88.189.111/wp-content/uploads/2024/05/protect-all-the-skin-sun-protection-1200x630-1-1024x538.webp" alt="" class="wp-image-32917" srcset="https://blogcms.23andme.com/wp-content/uploads/2024/05/protect-all-the-skin-sun-protection-1200x630-1-1024x538.webp 1024w, https://blogcms.23andme.com/wp-content/uploads/2024/05/protect-all-the-skin-sun-protection-1200x630-1-300x158.webp 300w, https://blogcms.23andme.com/wp-content/uploads/2024/05/protect-all-the-skin-sun-protection-1200x630-1-768x403.webp 768w, https://blogcms.23andme.com/wp-content/uploads/2024/05/protect-all-the-skin-sun-protection-1200x630-1-880x462.webp 880w, https://blogcms.23andme.com/wp-content/uploads/2024/05/protect-all-the-skin-sun-protection-1200x630-1-1180x620.webp 1180w, https://blogcms.23andme.com/wp-content/uploads/2024/05/protect-all-the-skin-sun-protection-1200x630-1.webp 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>



But people with darker skin are more likely to be diagnosed with melanoma at a later stage when it can be harder to treat. In addition, people with darker skin are much more likely to develop melanoma in parts of the body that get less sun, such as the palms of the hands, soles of the feet, beneath the fingernails, or even inside the mouth.



<div style="float: right; text-align: justified; width: 300px; background-color: #eee; padding: 15px; margin-left: 10px;">
The ABCDEs of melanoma
 
A: Asymmetry. Does one half look different than the other?
 
B: Border. Does it have an irregular edge?
 
C: Color. Does it have multiple colors? 
 
D: Diameter. Is it longer than 6mm across or about the diameter of a pencil eraser? 
 
E: Evolving. Is it changing over time? 

</div>



That&#8217;s why both prevention and skin self-exam are so important. Experts recommend knowing the <a href="https://www.aad.org/public/diseases/skin-cancer/find/at-risk/abcdes">ABCDEs of melanoma</a> (see sidebar) and performing a skin self-exam about once a month. It&#8217;s essential to monitor your skin and talk to a healthcare professional, like a dermatologist, if you notice any changes, including new or changed moles, bumps, or sores.



Early detection — often through self-exam and regular mole checks by a dermatologist — can also go a long way toward ensuring healthy outcomes. There&#8217;s another tool for assessing one&#8217;s risk, and that&#8217;s looking at your genetics.



<h2 class="wp-block-heading" id="h-23andme">23andMe+</h2>



As part of 23andMe+ Premium, members can access two reports to assess their genetic likelihood of developing one of these three common types of skin cancer.&nbsp;



<figure class="wp-block-image alignright size-large"><img loading="lazy" decoding="async" width="355" height="218" src="http://35.88.189.111/wp-content/uploads/2022/01/melanoma-story-1.ee0eb73ae029.svg" alt="" class="wp-image-29458"/></figure>



The service offers a Skin Cancer (Melanoma) report and a Skin Cancer (Basal and Squamous Cell Carcinomas) report. Both reports use polygenic risk scores (PRS) to assess a member&#8217;s likelihood of developing one of these cancers. These statistical models consider a person&#8217;s genetic ancestry and birth sex.&nbsp;



The reports also include some prevention tips. Some of these tips are obvious but also bear repeating. For instance, knowing that repeated sunburns substantially increase the risk is a reminder to use sunscreen and protect yourself from too much sun. However, research has also found that genetic factors and specific traits play a role.&nbsp;



Not long ago, using data from 23andMe customers who consented to participate in research, researchers from Indiana University found genetic variants associated with <a href="https://blog.23andme.com/23andme-research/new-genetic-research-on-skin-cancer/">squamous cell carcinomas</a>. A few years before, researchers at Stanford, also using 23andMe data, <a href="https://blog.23andme.com/articles/new-study-on-genetics-of-common-type-of-skin-cancer">found genetic variants associated</a> 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.&nbsp;



<figure class="wp-block-image alignright size-large"><img loading="lazy" decoding="async" width="302" height="160" src="http://35.88.189.111/wp-content/uploads/2022/01/melanoma-story-4.d0a1c76c810e.svg" alt="" class="wp-image-29457"/></figure>



<h2 class="wp-block-heading" id="h-what-you-can-do">What You Can Do</h2>



Being vigilant, especially for new moles or discolored skin, and protecting your skin from the sun can all help lower the likelihood of developing skin cancer.



A self-examination is a little more challenging for areas like the back, so having a partner, doctor, or a dermatologist take a look is a good idea.



Everyone should be aware of the risk of skin cancer, but some individuals have more risk than others. Individuals with lighter skin, many moles, who sunburn easily, or who have a family history of skin cancer should be particularly vigilant.&nbsp;



Wearing sun protection (like &#8220;broad spectrum&#8221; sunscreen and protective clothing) outdoors is essential—even when it’s cloudy. Avoiding tanning beds is also important.&nbsp;



<h2 class="wp-block-heading" id="h-more">More</h2>



23andMe&#8217;s skin cancer reports are available to all annual 23andMe+ Premium Membership subscribers.&nbsp; Premium members can view your report <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>.&nbsp;



Are you still waiting to be a23andMe+ Premium member?



Find out more <a href="https://www.23andme.com/membership">here</a>.



<hr class="wp-block-separator has-alpha-channel-opacity"/>



<h2 class="wp-block-heading" id="h-faq">FAQ</h2>



<div class="schema-faq"><div class="schema-faq-section" id="faq-question-1715726714056">What is melanoma? Melanoma is a common and serious form of skin cancer that can originate from moles. Early detection offers the best chance for treatment, so it&#8217;s essential to get familiar with your moles to notice changes that could signal that a mole is becoming cancerous. Only about two percent of skin cancers are melanoma, but this aggressive form of cancer is responsible for most skin cancer deaths. Melanomas are more likely than other skin cancers to be lethal because they can spread locally or metastasize to different parts of the body. While ultraviolet radiation from sun exposure and skin characteristics like moles, freckles, or light skin tones are key factors in the risk for melanoma, genetic factors also play a role. Again, this is why early detection is so important so that they can be treated before cancer can spread. </div> <div class="schema-faq-section" id="faq-question-1715726734989">What is basal cell carcinoma? Basal cell carcinoma is very common. This form of cancer begins in basal cells found in the skin&#8217;s outer layer. The most common cause of basal cell carcinoma is too much exposure to ultraviolet (UV) light from the sun. This can happen even on a cloudy day or through a glass window. In addition, UV light exposure from tanning beds and sun lamps increases the risk. Basal cell carcinoma also most often occurs in areas of the skin that are most exposed, such as the face, head, and neck, but it can happen anywhere. For people with darker skin, squamous and basal cell carcinomas often appear more like a dark brown or black bump that might be glossy and have a rolled border. The first sign is typically a bump, growth, or sore that doesn&#8217;t heal. Basal cell carcinoma is very treatable and tends to grow slowly. </div> <div class="schema-faq-section" id="faq-question-1715726753850">What is squamous cell carcinoma? Like basal cell carcinoma, squamous cell carcinoma often occurs due to too much exposure to UV light from the sun or other sources like tanning beds or sun lamps. Like basal cell carcinoma, it most often occurs in areas of the skin that are most exposed, but squamous cell carcinoma is more likely to happen on the scalp, the backs of hands, ears, and lips. However, as with basal cell carcinoma, it can develop in other areas. For example, among people with darker skin, squamous cell carcinoma commonly appears on the legs and other areas that typically get less sun exposure. For people with darker skin, squamous and basal cell carcinomas often seem more like a dark brown or black bump that might be glossy and have a rolled border. The first sign is typically a bump, growth, or sore that doesn&#8217;t heal. Squamous carcinoma is very treatable and tends to grow slowly. </div> </div>



<hr class="wp-block-separator has-alpha-channel-opacity"/>

Understand Your Genetics Likelihood of Developing Skin Cancer

Raising Awareness about Blood Clotting Risk for Women

As part of <a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2024/03/29/a-proclamation-on-cancer-control-month-2024/">National Cancer Prevention and Early Detection Month</a>, 23andMe is joining <a href="https://www.preventcancer.org/wp-content/uploads/2024/03/2024_White_House_partner_letter_Cancer_Prevention_Early_Detection_FINAL.pdf">other voices</a> in April to raise awareness.&nbsp;



By sharing insights with our customers about cancer risk, we aim to highlight the importance of knowing one’s family health history, getting appropriate cancer screenings, and understanding the role of genetics and lifestyle in cancer risk.



“Probably the most important thing 23andMe does is help people understand whether they have an increased likelihood of cancer based on their genetics, often information that they would not have known otherwise,” said Noura Abul-Husn, MD, PhD, Vice President of Genomic Health at 23andMe. “But we also highlight for everyone the importance of family health history and other factors that contribute to cancer risk.”



23andMe does not diagnose cancer, but thousands of 23andMe customers have learned of their genetic likelihood of developing different forms of cancer.* This, in turn, has empowered them with information that they and their doctors can use to take preventive steps and personalize care. Those steps might include confirmatory testing of genetic risk, earlier or more frequent cancer screenings, or, when necessary, preventative surgery. Sometimes, the next steps might focus more on changes in diet and exercise to help reduce risk and prevent cancer.



Finding out early about a risk, or learning that you have cancer in the very early stages, offers the most potential for prevention or treatment. Large numbers of individuals who are at risk, or may be in the early stages of cancer, remain unaware.&nbsp;



One study in 2019 found that almost a quarter of prostate cancers and about a third of breast cancers are diagnosed in the <a href="https://progressreport.cancer.gov/diagnosis/stage">late stage of the disease</a>. Unfortunately it’s likely that for other cancers that may be harder to detect or for which screening is not as readily available, the percentage of those that are only detected in the later stages is even higher.



<h2 class="wp-block-heading" id="h-taking-action">Taking Action</h2>



At 23andMe, we’ve also seen firsthand the transformative power this knowledge has given people.



This includes people like <a href="https://blog.23andme.com/articles/a-mother-and-daughters-fight-against-cancer">Kenzie and her mom, Shannon</a>. Kenzie learned from her <a href="https://www.23andme.com/brca/">23andMe BRCA1/BRCA2 (Selected Variants) Genetic Health Risk Report</a>* that she had a BRCA1 variant that put her at a much higher risk for breast, ovarian, and other cancers. Her mom, Shanon, had gone through treatment for a form of blood cancer when Kenzie was in her teens. Because of her cancer history, Shannon made an appointment with her oncologist, where she shared the news about Kenzie’s report. She was referred to a genetic counselor, who immediately set Shannon up for genetic testing. Kenzie also got confirmatory testing. It turned out that both mother and daughter carry the BRCA1 variant putting them at higher risk for cancer. 



Shannon said that learning of her and her daughter’s genetic risk for cancer was transformative and allowed them to work with their doctors to take action.&nbsp;



“I think for me, how quickly we were able to move through this process to take control, that’s powerful,” said Shannon. “When I feel a little deflated or sad that Kenzie has this (risk), I worry about her; Kenzie reminds me of how blessed we are to have this knowledge. Look at what we’ve been able to do, not to get breast cancer. It’s an inspiration.”



For Shannon and Kenzie, addressing their risk meant preventive surgeries and more frequent cancer screening. Other individuals may choose different options depending on their risk, but knowing one’s risk is the critical first step in prevention. 



Cancer and Genetics



Up to ten percent of all cancers are <a href="https://www.cancer.gov/about-cancer/causes-prevention/genetics">due to inherited genetic variants</a> passed down through families. In genes like BRCA1 and BRCA2, these variants significantly impact cancer risk.



For people with these highly impactful variants, clinical guidelines recommend enhanced screening and, in some cases, preventive surgeries and medications. But most people with these variants don&#8217;t know they have them.



For example, studies have found that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324494/">more than 80 percent</a> of people with a BRCA1 or BRCA2 variant don’t know they have it. Many do not have a family history of cancer that would qualify them for traditional genetic testing through a healthcare professional. Layered onto that are disparities in access to BRCA1/2 genetic testing in some communities in the U.S., including the Black, Hispanic/Latino, and Asian communities.



We&#8217;ve heard from many customers who learned they had a BRCA variant through 23andMe. This includes <a href="https://www.youtube.com/watch?v=msBITuIygtw">Ann</a>, whose knowledge allowed her to make a decision about her body from a place of being healthy. <a href="https://blog.23andme.com/articles/sarahs-23andme-report-leads-to-preventative-action">Sarah</a>’s 23andMe report alerted her and her doctors and allowed her to catch her breast cancer at a very early stage. There’s also&nbsp; <a href="https://blog.23andme.com/articles/after-the-click-brca">Laura</a>, who said that finding out she had a BRCA variant gave her a chance to “change (her) destiny.”&nbsp;



<h2 class="wp-block-heading" id="h-other-factors">Other Factors</h2>



Thankfully, variants with a big impact on cancer risk are relatively rare — for example, about 1 in 200 people in the general population has a BRCA1 or BRCA2 variant. However, these variants are more common in certain populations, such as people with Ashkenazi Jewish ancestry.



For people without a high-risk variant, genetics can still play an important role. In these cases, the chances of developing cancer are influenced by thousands of common variants that each have a small effect. It’s these common genetic variants combined with lifestyle and environment that increased the likelihood of a majority of cancer.



Non-genetic factors that impact cancer risk include such things as ultraviolet radiation from the sun, smoking tobacco, chemical exposures, viruses, or other carcinogenic exposures that damage cells and could trigger the growth of cancer.&nbsp;



Understanding one’s risk and the mix of genetic and non-genetic factors in that risk can also highlight that we are not powerless. Estimates suggest that <a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2024/03/29/a-proclamation-on-cancer-control-month-2024/">about 30 percent of cancers</a> are preventable through making healthier choices, whether it&#8217;s stopping smoking, limiting alcohol consumption, or getting enough exercise. 



But cancers can also happen to people who make all the right choices around diet and exercise, and who don&#8217;t have any known genetic risk factors. For example, non-smokers can still get lung cancer. This is one reason why early detection — through routine screening and talking with a healthcare professional about any new or concerning symptoms — is so important.&nbsp;



Each cancer is different but they all share something in common: a disruption of the normal process of cell division and growth in our bodies. Cancer hijacks this process, allowing abnormal cells to grow, divide, and metastasize into other body parts.&nbsp;



Left unchecked cancer can spread throughout the body making it very difficult to treat. That’s why improved early screening for cancers and access to healthcare are also so crucial in preventing cancer and detecting it early.     



<h2 class="wp-block-heading" id="h-knowledge-is-power">Knowledge is Power</h2>



Caught early, most cancers are treatable. But catching cancer early — or preventing it entirely — requires better screening or knowing who may be at the higher risk because of a genetic risk for cancer, or a family history of cancer, or because of lifestyle or environmental exposures.



Something as simple as learning your family’s cancer history is tremendously important. Just consider that the <a href="https://www.cancer.org/cancer/types/breast-cancer/risk-and-prevention/breast-cancer-risk-factors-you-cannot-change.html">risk for breast cancer nearly doubles</a> if a sibling or parent has ever had breast cancer, for instance. 23andMe offers tools for tracking family health history. There are also other tools for tracking this information including the free online tool from the Surgeon General called <a href="https://cbiit.github.io/FHH/html/index.html">My Family Health Portrait.</a>&nbsp;&nbsp;



Sometimes, the information we learn from our family history or from genetic testing can be life-changing. Other times, information from genetic testing can be more subtle than that, nudging us toward healthier actions. Learning your genetics increases your likelihood of developing skin cancer, for example, reminds you to be more diligent about sunscreen, and can motivate you to follow through on seeing a dermatologist for regular skin checks. 



<h2 class="wp-block-heading" id="h-learn-more">Learn More</h2>



23andMe provides customers with two types of genetic reports on cancer.



In our Genetic Health Risk reports, we report on individual variants with a big impact on cancer risk. These reports include our BRCA1/BRCA2 (Selected Variants) report*, which tests for 44 variants associated with a higher risk for breast, ovarian, prostate, and pancreatic cancer; our MUTYH-Associated Polyposis report*, which tests for 2 variants that increase risk for colorectal cancer; and our 23andMe+ Premium Hereditary Prostate Cancer (HOXB13-Related) report*, which tests for one variant that increases risk for prostate cancer.



In our reports powered by 23andMe research, we use data from consented 23andMe research participants to develop polygenic scores that take into account thousands of common, small-impact variants to provide information about the chances of developing cancer. For 23andMe+ Premium members, we currently offer this type of report on some of the most common types of cancer: breast, prostate, and colorectal cancer, along with two reports related to skin cancer (basal and squamous cell carcinomas, and melanoma). For each of these cancer reports, 23andMe offers follow-up recommendations.&nbsp;



<h2 class="wp-block-heading" id="h-find-out-more">Find Out More</h2>



Learn more about all that 23andMe has to offer and <a href="https://www.23andme.com/compare-dna-tests/">compare our services here</a>.



<h6 class="wp-block-heading" id="h-disclaimer">*Disclaimer:</h6>



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 and reporting carrier status. 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. Our carrier status reports can be used to determine carrier status, but cannot determine if you have two copies of any genetic variant. These carrier reports are not intended to tell you anything about your risk for developing a disease in the future, the health of your fetus, or your newborn child&#8217;s risk of developing a particular disease later in life. For certain conditions, we provide a single report that includes information on both carrier status and genetic health risk. 



<h6 class="wp-block-heading" id="h-warnings-amp-limitations">Warnings &amp; Limitations: </h6>



The 23andMe PGS Genetic Health Risk Report for BRCA1/BRCA2 (Selected Variants) is indicated for reporting of 44 variants in the BRCA1 and BRCA2 genes. The report describes if a person&#8217;s genetic result is associated with an increased risk of developing breast cancer and ovarian cancer and may be associated with an increased risk for prostate cancer, pancreatic cancer, and potentially other cancers. The variants included in this report do not represent the majority of the BRCA1/BRCA2 variants in people of most ethnicities. The MUTYH-Associated Polyposis Genetic Health Risk Report is indicated for reporting the Y179C and G396D variants in the MUTYH gene and an increased risk for colorectal cancer. The two variants included in this report are most common in people of Northern European descent. The Hereditary Prostate Cancer (HOXB13-Related) Genetic Health Risk report is indicated for reporting the G84E variant in the HOXB13 gene. The report describes if a person has the G84E variant and if a male is at increased risk for prostate cancer. The variant included in this report is most common in people of European descent, especially in people of Northern European descent. These reports do not include variants in other genes linked to hereditary cancers and the absence of variants included in these reports do not rule out the presence of other genetic variants that may impact cancer risk. The PGS test is not a substitute for visits to a healthcare professional for recommended screenings or appropriate follow-up. Results should be confirmed by an independent genetic test prescribed by your own healthcare provider before taking any medical action. For important information and limitations regarding all genetic health risk reports, visit <a href="https://www.23andme.com/test-info/">https://www.23andme.com/test-info</a>.

An illustration showing families exercising.

Understanding the Risk Is the First Step in Preventing Cancer

By Mikala Evans, MPH



Welcome to “Mind Body Wellness,” a column that aims to help you develop a deeper understanding of your health. 



<figure class="wp-block-image alignright size-medium"><img loading="lazy" decoding="async" width="300" height="300" src="http://35.88.189.111/wp-content/uploads/2024/03/Evans-headshot-300x300.jpeg" alt="" class="wp-image-32651" srcset="https://blogcms.23andme.com/wp-content/uploads/2024/03/Evans-headshot-300x300.jpeg 300w, https://blogcms.23andme.com/wp-content/uploads/2024/03/Evans-headshot-150x150.jpeg 150w, https://blogcms.23andme.com/wp-content/uploads/2024/03/Evans-headshot-271x271.jpeg 271w, https://blogcms.23andme.com/wp-content/uploads/2024/03/Evans-headshot-372x372.jpeg 372w, https://blogcms.23andme.com/wp-content/uploads/2024/03/Evans-headshot.jpeg 500w" sizes="auto, (max-width: 300px) 100vw, 300px" /><figcaption class="wp-element-caption">Mikala Evans, MPH</figcaption></figure>



With genetics in mind, I’m tackling common topics and breaking down issues that impact your health journey. With so much information coming at us daily, it’s hard to know what’s best for our health and what we should ignore. 



Is red wine good for you, or should you never touch alcohol? And what on earth is acetaldehyde? 



Navigating all of this information can be exhausting.



My name is Mikala, and I’m here to be your guide. I don’t mind sifting through studies and papers to summarize key takeaways (because I really like this stuff!)  My interest in science began in college, studying biochemistry. However, it wasn’t until I joined the 23andMe Customer Care team in 2015 and helped people answer questions about their genetic reports through thousands of emails and phone calls that I realized how daunting this journey can be. This ultimately led me to a master’s degree in public health, where I quickly learned that my favorite aspect of graduate school was that it was a little unique. As a teaching assistant in a cell biology course, I loved seeing students’ eyes light up when they finally understood a new biological concept. I felt privileged to help them gain new knowledge and understanding. 



My time in Customer Care and my students’ experience perfectly captures my goal for this blog. Not only do I want to break down health topics, I want you to start to feel more comfortable approaching scientific concept papers. We will cover a range of diverse issues, and I hope you get educational content that leads to conversations, reflection, and even action. 



Join me as I take on diet, exercise, mindfulness, and new developments around common health issues like heart disease, diabetes, and cancer using a holistic lens backed by scientific literature. I can’t wait to start this journey towards improving our understanding of mind and body wellness!



Everything is always better as a game — including biology. Here is the first of many health trivia questions! 



What is the most abundant element in the human body by mass?* (no cheating!)



Mikala Evans&#8217; time with 23andMe goes back to 2015 when she worked with our Customer Care team. She returned to the company after receiving her master&#8217;s in public health from UCLA, where she trained in epidemiology and focused her studies on asthma within a community in Los Angeles exposed to natural gas pollution. After returning to 23andMe, Mikala has worked as a quality engineer focused on compliance. She has a bachelor of science in biochemistry and a minor in religious studies from Washington University in St. Louis. She loves her two nieces and exploring all the natural beauty in Northern California. 



*Answer: Oxygen

Mikala Evans

Mind Body Wellness

This week, 23andMe released new reports on three of the most common types of cancer — <a href="https://www.cdc.gov/cancer/breast/basic_info/">breast cancer,</a> <a href="https://www.cdc.gov/cancer/prostate/basic_info/">prostate cancer</a>, and <a href="https://www.cdc.gov/cancer/colorectal/basic_info/what-is-colorectal-cancer.htm">colorectal cancer</a>.&nbsp;



The new reports use thousands of genetic variants associated with the disease to assess a person’s likelihood of an individual developing one of these cancers.



The reports are based on statistical models known as polygenic risk scores (PRS), developed by 23andMe through its proprietary research database. These new PRS reports were developed by 23andMe scientists and clinical experts using the company’s massive database of genetic and self-reported health information contributed by consented research participants.



<h2 class="wp-block-heading" id="h-the-new-cancer-prs-reports">The New Cancer PRS Reports</h2>



The new 23andMe PRS reports focus on some of the most common cancers for which genetics are often a factor, noting where some customers may have an increased likelihood of developing these conditions relative to the average. This is important because averages can mask significant differences – some people have a higher chance of developing cancer, and some have a slightly lower chance due to genetics and other factors. Significantly, healthy lifestyle habits can offset an increased genetic likelihood of developing these diseases, while routine screening can help with early detection.



Breast cancer affects, on average, one in eight females, while prostate cancer affects about one in eight males, and colorectal cancer impacts about one in 25 people.



For these reports, depending on the type of cancer and the member’s ancestry, up to 5-to-30 percent of our current <a href="https://www.23andme.com/membership/">23andMe+ Premium</a> and <a href="https://www.23andme.com/total-health/">23andMe+ Total Health</a> members will see an increased likelihood result.&nbsp;



It’s important to note that these three new cancer reports — <a href="https://you.23andme.com/reports/prs.breast_cancer/">Breast Cancer PRS Report</a>*, <a href="https://you.23andme.com/reports/prs.prostate_cancer/">Prostate Cancer PRS Report</a>*, and <a href="https://you.23andme.com/reports/prs.colorectal_cancer/">Colorectal Cancer PRS Report</a>* — augment or work in parallel with three existing Genetic Health Risk reports* that look at select variants associated with these types of cancers.&nbsp;



Although each report examines how a customer’s genetics can impact the chances of developing cancer, the reports differ in several ways. One way to look at them is to consider the different causes of cancer.



Cancer can be caused by rare genetic variants that have a significant impact on the risk of developing cancer. These highly impactful variants are part of our Genetic Health Risk reports. Other times, cancer can be influenced by thousands of common variants that each have a small effect on the likelihood of developing cancer. But a lot of small impact variants can make a big impact. 23andMe’s new PRS reports consider many common variants to report the likelihood of developing cancer. It’s these common genetic variants combined with lifestyle and environment that cause the majority of cancer.



23andMe’s existing Genetic Health Risk reports include the <a href="https://blog.23andme.com/articles/23andme-updates-brca1-2-report">BRCA1/BRCA2 (Selected Variants)</a>* report, the <a href="https://blog.23andme.com/articles/23andmes-new-hereditary-prostate-cancer-hoxb13-related-report">Hereditary Prostate Cancer (HOXB13-Related)</a>* report, and the <a href="https://blog.23andme.com/articles/23andmes-new-mutyh-report">MUTYH-Associated Polyposis (MAP)</a>* report. If a customer has an increased risk detected in one of those reports, they will not receive a result for the related PRS report.



<h2 class="wp-block-heading" id="h-a-caveat-regarding-the-new-colorectal-cancer-report">A Caveat Regarding the New Colorectal Cancer Report</h2>



The new colorectal cancer PRS report is only available for those of European and Latino/Hispanic descent, as there is not yet enough data to provide a result for those of other ethnicities &#8211; a historical issue with genetic research and polygenic scores at large. As the number of customers opting to participate in our research grows, we may be able to improve the model performance within these groups.&nbsp;



To help address this issue, 23andMe recently launched <a href="https://www.23andme.com/genetic-insights-into-colorectal-cancer-black-community/">Genetic Insights into Colorectal Cancer in the Black Community</a> study, which invites individuals with African ancestry and/or who identify as Black or African American to participate. In the U.S., Black and African Americans have an increased chance of developing and dying from colorectal cancer compared to many other ethnic groups. We hope to use the insights gained from this study to help more customers understand their chances of developing the disease. In the fall of 2023, we updated our BRCA1/BRCA2 (selected variants) report to include 44 variants and improve its coverage for people of non-European ancestry.&nbsp;



<h2 class="wp-block-heading" id="h-find-out-more-about-23andme-s-new-cancer-prs-nbsp">Find Out More About 23andMe’s New Cancer PRS&nbsp;</h2>



The hope is that these new PRS reports will help our customers become more informed, alerting them to an increased likelihood of developing cancer that they would not have known otherwise.



The three new PRS reports are available to <a href="https://www.23andme.com/membership/">23andMe+ Premium</a> members and <a href="https://www.23andme.com/total-health/">23andMe+ Total Health</a> members. Because these three new cancer reports cover similar conditions covered in three of our previously released sensitive reports—BRCA1/BRCA2 (Selected Variants), Hereditary Prostate Cancer (HOXB13-Related), and MUTYH-Associated Polyposis—we require customers to opt-in and view any tutorials associated with those sensitive reports in order to view their new cancer reports.&nbsp;



While the new reports do not include suggestions for clinical action and do not diagnose cancer, they do highlight healthy lifestyle habits, the importance of keeping up to date with screening, and what to discuss with your healthcare provider.



<h2 class="wp-block-heading" id="h-learn-more">Learn More</h2>



23andMe+ Premium members can find links to three new PRS reports on the new topic pages.



<ul class="wp-block-list">
<li><a href="https://you.23andme.com/health/condition/breast_cancer/">Breast Cancer </a>(only available for customers who self-reported their birth sex as female)</li>



<li><a href="https://you.23andme.com/health/condition/prostate_cancer/">Prostate Cancer </a>(only available for customers who self-reported their birth sex as male)</li>



<li><a href="https://you.23andme.com/health/condition/colorectal_cancer/">Colorectal Cancer&nbsp;</a></li>
</ul>



These new topic pages explain how the new cancer reports work with 23andMe’s existing Genetic Health Risk reports. In addition, the pages include information about the factors influencing the chances of developing one of these cancers and the importance of knowing your family health history.



These new topic pages will also be available to all 23andMe <a href="https://www.23andme.com/dna-health-ancestry/">Health + Ancestry customers</a> on the <a href="https://customercare.23andme.com/hc/en-us/articles/218392668-Upgrading-to-23andMe-s-Newest-Chip-Version">latest genotyping chip</a>, V5.&nbsp;



Find out all that 23andMe has to offer and <a href="https://www.23andme.com/compare-dna-tests/">compare our services here</a>.



<hr class="wp-block-separator has-alpha-channel-opacity"/>



<h2 class="wp-block-heading" id="h-disclaimer">Disclaimer</h2>



*The 23andMe PGS test includes health predisposition and carrier status reports. Health predisposition reports include both reports that meet FDA requirements for genetic health risks and PRS reports which are based on a statistical model that includes data and insights from 23andMe consented research participants, 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 and reporting carrier status. 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. Each PRS report describes if a person has a certain likelihood of developing a condition, but does not describe a person’s overall likelihood. 



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. Our carrier status reports can be used to determine carrier status, but cannot determine if you have two copies of any genetic variant. These carrier reports are not intended to tell you anything about your risk for developing a disease in the future, the health of your fetus, or your newborn child&#8217;s risk of developing a particular disease later in life. For certain conditions, we provide a single report that includes information on both carrier status and genetic health risk. 



<h2 class="wp-block-heading" id="h-warnings-amp-limitations">Warnings &amp; Limitations: </h2>



The 23andMe PGS Genetic Health Risk Report for BRCA1/BRCA2 (Selected Variants) is indicated for reporting of 44 variants in the BRCA1 and BRCA2 genes. The report describes if a person&#8217;s genetic result is associated with an increased risk of developing breast cancer and ovarian cancer and may be associated with an increased risk for prostate cancer, pancreatic cancer, and potentially other cancers. 



The variants included in this report do not represent the majority of the BRCA1/BRCA2 variants in people of most ethnicities. The MUTYH-Associated Polyposis Genetic Health Risk Report is indicated for reporting the Y179C and G396D variants in the MUTYH gene and an increased risk for colorectal cancer. The two variants included in this report are most common in people of Northern European descent. The Hereditary Prostate Cancer (HOXB13-Related) Genetic Health Risk report is indicated for reporting the G84E variant in the HOXB13 gene. The report describes if a person has the G84E variant and if a male is at increased risk for prostate cancer. The variant included in this report is most common in people of European descent, especially in people of Northern European descent. 



These reports do not include variants in other genes linked to hereditary cancers and the absence of variants included in this report does not rule out the presence of other genetic variants that may impact cancer risk. These reports are for over-the-counter use by adults, and provide genetic information to inform discussions with a healthcare professional. The PGS test is not a substitute for visits to a healthcare professional for recommended screenings or appropriate follow-up. Results should be confirmed by an independent genetic test prescribed by your own healthcare provider before taking any medical action.&nbsp; For important information and limitations regarding genetic health risk reports, visit https://www.23andme.com/test-info.

An image of the three Cancer PRS reports displayed on a mobile phone.

23andMe Launches New Genetic Reports on Common Forms of Cancer

You may use your FSA or HSA for 23andMe health offerings. Learn more today and get started. 
Here’s some good news if you’re among the millions of people in the United States with a healthcare Flexible Spending Account (FSA) or Health Saving Account (HSA): 23andMe health offerings may be fully or partially eligible for <a href="https://www.23andme.com/fsa-hsa/">use of FSA or HSA dollars</a>. 
23andMe’s health offerings include health reports, features, and services that are part of <a href="https://www.23andme.com/dna-health-ancestry/">23andMe Health + Ancestry Service</a>, <a href="https://www.23andme.com/membership/">23andMe+ Premium</a>™ and <a href="https://www.23andme.com/total-health/">23andMe+ Total Health</a>.™ In addition, clinical lab tests and clinician fees coordinated through 23andMe are part of 23andMe’s health offerings. (See below for more detail on each of these services.)
<h2>IRS Changes to FSA and HSA in 2023 </h2>
Before diving into all that is eligible under 23andMe’s umbrella of offerings, knowing more about these flexible pre-tax spending accounts and what’s new is essential.
The IRS has significantly increased the amount of pre-tax income people can set aside in the two most common types of these accounts — Flexible Spending Accounts (FSA) and Health Saving Accounts (HSA). Like retirement savings accounts that allow people to save money with pre-tax income, these accounts are also pre-tax but earmarked for medical expenses. You can find out more about the two types of accounts <a href="https://www.irs.gov/government-entities/federal-state-local-governments/where-can-i-learn-more-about-health-savings-accounts-hsa-and-health-reimbursement-arrangements-hra">here</a>.*
The IRS recently increased the amount people can set aside for both of these types of accounts; for instance, individuals can set aside up to $3,850 in pre-tax income for the HSA account, while families can set aside $7,750.*
You can use this money for all sorts of “qualified medical expenses,” from co-pays for doctor’s visits to prescription medications to glasses and sunscreen. 
Are 23andMe’s health offerings a qualified medical expense? Yes, they are. Not too long ago, the <a href="https://permalinks.23andme.com/pdf/IRS_PLR132576_18.pdf?_gl=1*1crr0o3*_ga*MTYzNzM2NzYyNy4xNjcwODY5Nzcy*_ga_G330GF3ZFF*MTcwMTcwMjIwNy4xMjUuMS4xNzAxNzAyMjY3LjAuMC4w">IRS ruled </a>that you can use FSA or HSA money for 23andMe’s health offerings.
<h2>23andMe Services That Are FSA/HSA Eligible</h2>
The Internal Revenue Service also ruled in 2019 that the health portion of the cost of the 23andMe Health + Ancestry Service may be eligible. Customers can use our<a href="https://www.23andme.com/fsa-hsa-eligibility/calculator/"> FSA/HSA calculator </a>to determine how much is eligible. 
In 2021, 23andMe introduced the 23andMe Health Service which is FSA &amp; HSA eligible and includes health predisposition reports**, carrier status reports**, and wellness reports. The 23andMe Health Service is only available on the <a href="https://fsastore.com/23andme-health-only-service/32162.html">FSA/HSA store</a> and on <a href="https://www.amazon.com/23andMe-Health-Service-Including-Predispositions/dp/B09JFV4Z95?maas=maas_adg_9355566F4DC6DBE77B3FBD8B090C0C24_afap_abs&amp;ref_=aa_maas&amp;tag=maas">Amazon’s FSA/HSA store</a>. 
Now much more of 23andMe’s health offerings are eligible. For instance, the annual membership fees for <a href="https://www.23andme.com/membership/">23andMe+ Premium</a> and <a href="https://www.23andme.com/total-health/">23andMe+ Total Health</a> may be eligible for reimbursement based upon the IRS’s reasoning in their 2019 ruling. <a href="https://blog.23andme.com/articles/total-health/th-pdp-kit-1c9c1efa996d114d39464fcef61794cc" rel="attachment wp-att-32291"><img loading="lazy" decoding="async" class="size-full wp-image-32291 alignnone" src="http://35.88.189.111/wp-content/uploads/2023/10/th-pdp-kit.1c9c1efa996d114d39464fcef61794cc.png" alt="" width="1176" height="966" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/10/th-pdp-kit.1c9c1efa996d114d39464fcef61794cc.png 1176w, https://blogcms.23andme.com/wp-content/uploads/2023/10/th-pdp-kit.1c9c1efa996d114d39464fcef61794cc-300x246.png 300w, https://blogcms.23andme.com/wp-content/uploads/2023/10/th-pdp-kit.1c9c1efa996d114d39464fcef61794cc-768x631.png 768w, https://blogcms.23andme.com/wp-content/uploads/2023/10/th-pdp-kit.1c9c1efa996d114d39464fcef61794cc-1024x841.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2023/10/th-pdp-kit.1c9c1efa996d114d39464fcef61794cc-880x723.png 880w" sizes="auto, (max-width: 1176px) 100vw, 1176px" /></a>
 
Customers can use money from these accounts to cover such things as clinical lab tests and clinician fees coordinated through 23andMe and may also be able to apply funds from their FSA or HSA accounts to upgrade to 23andMe&#8217;s Health + Ancestry Service, 23andMe+ Premium, or 23andMe+ Total Health, which are considered eligible expenses. In addition, the IRS allows customers to use FSA/HSA funds for a portion (up to $189†) of the cost of the <a href="https://www.23andme.com/dna-health-ancestry/">23andMe Health + Ancestry Service</a>.
<a href="https://blog.23andme.com/articles/23andme-now-available-in-uk-at-boots-online/ha-kit-med_2x-7e3f651f61e3" rel="attachment wp-att-26768"><img loading="lazy" decoding="async" class="size-full wp-image-26768 alignnone" src="http://35.88.189.111/wp-content/uploads/2018/12/ha-kit-med_2x.7e3f651f61e3.jpg" alt="" width="552" height="286" srcset="https://blogcms.23andme.com/wp-content/uploads/2018/12/ha-kit-med_2x.7e3f651f61e3.jpg 552w, https://blogcms.23andme.com/wp-content/uploads/2018/12/ha-kit-med_2x.7e3f651f61e3-300x155.jpg 300w" sizes="auto, (max-width: 552px) 100vw, 552px" /></a>
<h2>Learn More</h2>
If you are trying to determine what portion of your purchase, membership, or upgrade may be  eligible, the simplest way to figure out the likely eligible amounts would be to use our <a href="https://www.23andme.com/fsa-hsa-eligibility/calculator/">FSA/HSA calculator</a>. We also have more details on our <a href="https://www.23andme.com/fsa-hsa/">FSA/HSA page</a>. Additionally, you should always check with your specific FSA/HSA benefits coordinator and/or your tax professional for confirmation on the specific requirements for reimbursement, including eligibility, usage, procedures, and qualifications. To purchase the 23andMe Health Service visit <a href="https://fsastore.com/23andme-health-only-service/32162.html">the FSAStore</a>, or go to Amazon <a href="https://www.amazon.com/23andMe-Health-Service-Including-Predispositions/dp/B09JFV4Z95?maas=maas_adg_9355566F4DC6DBE77B3FBD8B090C0C24_afap_abs&amp;ref_=aa_maas&amp;tag=maas">here</a>. 
Still have questions? Here are answers to some of the most frequently asked questions about <a href="https://customercare.23andme.com/hc/en-us/articles/360026466094">FSA &amp; HSA eligibility and 23andMe.</a>
Learn about all 23andMe has to offer <a href="https://www.23andme.com/compare-dna-tests/?bst=pff">here</a>. 


<hr class="wp-block-separator has-alpha-channel-opacity"/>


<h2>Note:</h2>
This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. 23andMe does not provide tax, legal, or accounting advice. You should consult your specific FSA/HSA benefits coordinator and/or your tax professional for further information regarding the application of the tax laws and confirmation on the specific requirements for reimbursement, including eligibility, usage, procedures, and qualifications. 
*Check with your specific FSA/HSA benefits coordinator and/or your tax professional for confirmation on the specific requirements for reimbursement, including eligibility, usage, procedures, and qualifications. 
**The 23andMe PGS test includes health predisposition and carrier status reports. 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. Our carrier status reports can be used to determine carrier status, but cannot determine if you have two copies of any genetic variant. These carrier reports are not intended to tell you anything about your risk for developing a disease in the future, the health of your fetus, or your newborn child&#8217;s risk of developing a particular disease later in life. For certain conditions, we provide a single report that includes information on both carrier status and genetic health risk. For important information and limitations regarding each genetic health risk and carrier status report, visit 23andme.com/test-info/.
†Based on the purchase price of $229. Check with your FSA/HSA administrator and/or your tax professional for specific requirements for individual eligibility and reimbursement. 


<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="1024" height="1024" src="http://35.88.189.111/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-1024x1024.png" alt="" class="wp-image-29342" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-1024x1024.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-150x150.png 150w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-300x300.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-768x768.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-880x880.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-1180x1180.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-271x271.png 271w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-372x372.png 372w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-574x574.png 574w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit-980x980.png 980w, https://blogcms.23andme.com/wp-content/uploads/2021/11/Amazon-Thumbnail-HO-Kit.png 1500w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>

23andMe Health Offerings Are FSA & HSA Eligible

Good health depends on a good night’s rest, but in the wee hours, sleep eludes many of us; some estimates suggest that as many as<a href="https://pubmed.ncbi.nlm.nih.gov/28348990/"> 30 percent of adults</a> have insomnia, defined as an inability to fall asleep at least three times a week over several months.



Many factors, such as stress, certain medications, poor sleep hygiene, or alcohol or caffeine close to bedtime, can play a role in why some of us toss and turn each night. But genetics also influences our ability to sleep.



This week, 23andMe released a new Insomnia report (Powered by 23andMe Research) and available to 23andMe+ Premium members.



<h6 class="wp-block-heading" id="h-about-the-report">About the Report</h6>



The new 23andMe+ report on insomnia uses data from people who have consented to participate in 23andMe research. Leveraging this data, we use machine learning techniques to estimate an individual’s likelihood of developing insomnia.



The estimates factor in that data and use statistical modeling that includes thousands of genetic markers and information on an individual’s ethnicity and birth sex. Together, all this data is used to calculate the genetic likelihood of developing&nbsp; insomnia. Customers can learn more about the science and methodology behind our new report in this<a href="https://permalinks.23andme.com/pdf/23_21-PRSMethodology_May2020.pdf"> white paper</a>.



The report provides users with helpful information on their estimated genetic likelihood of developing insomnia, but it is not a substitute for clinical diagnosis or treatment.



<h6 class="wp-block-heading" id="h-what-is-insomnia">What is Insomnia?</h6>



All of us struggle to get to sleep occasionally, but insomnia causes persistent problems with not just falling asleep but staying asleep. Insomnia can last a few days or weeks, but when it lasts more than three months or more, it is considered chronic.



Beyond external factors like stress, diet, or medication, scientists are still trying to understand the genetics of insomnia fully.



<a href="https://blog.23andme.com/articles/genetics-of-insomnia-more-similar-to-psychiatric-conditions-than-to-other-sleep-traits">Insomnia</a> is highly polygenic, meaning many different genes are associated with the condition. Still, several studies have narrowed down on a combination of genetic factors that contribute to the disruption of the sleep-wake cycle or change the chemical cycles in the brain that control sleep. In 2022, 23andMe collaborated with researchers at Vrije University in Amsterdam that included data from more than 2.3 million individuals and identified<a href="https://blog.23andme.com/articles/insomnia-study"> 289 genetic variants associated with insomnia</a>.



The impact of sleep or the lack of sleep has been well studied. The more obvious symptoms are daytime drowsiness, low energy, and trouble concentrating or remembering things. Drowsiness itself contributes to other public safety issues, such as<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831237/"> car accidents</a>. But insomnia can also impact mental health. It’s associated with depression and anxiety, for instance. Long-term insomnia is also associated with health conditions such as high blood pressure, heart disease, and diabetes.&nbsp;



For people who have chronic insomnia, <a href="https://www.nhlbi.nih.gov/health/insomnia/treatment">treatment</a> with cognitive behavioral therapy and lifestyle modifications can help address the causes of insomnia. In extreme cases, doctors may recommend sleep-aid medications that can help too.



<h6 class="wp-block-heading" id="h-more-on-sleep">More on Sleep</h6>



Sleep allows our bodies and brains to shut down and rest. But there is more going on during sleep, especially during the various stages of sleep, each linked to different electrical patterns in our brains that all likely play an essential role in health.



There are two types of sleep — rapid eye movement or REM sleep and non-REM sleep. Non-REM sleep is often where we begin, and it is characterized by a slowing down of your heart rate and breathing but a period during which you are more easily awakened.&nbsp;



There are different stages of non-REM sleep, with each stage characterized by slower brain waves; the <a href="https://blog.23andme.com/articles/sleepy-time">deepest stage of non-REM sleep</a> includes periods with very low frequency waves, known as Delta waves, and is considered restorative.



You dream during REM sleep. The stage is characterized not just by rapid eye movement but also by rapid breathing and heart rate and blood pressure increases. Typically, a person enters REM sleep an hour or an hour after falling asleep, lasting about 10 minutes to an hour. After REM sleep, the process repeats. Typically, about a fifth of our sleep is REM sleep. 



Dreams and REM sleep help with learning and making memories. Other stages of sleep, for instance, are crucial for creating pathways for learning and remembering.



Researchers are still trying to understand why sleep is so essential. 23andMe scientists and their collaborators have looked at several components of sleep, including <a href="https://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1006125">wake times</a>,<a href="https://research.23andme.com/wp-content/uploads/2018/10/Y_Huang_ASHG18_final.pdf"> sleep apnea,</a> and <a href="https://www.sciencedirect.com/science/article/abs/pii/S019745802030124X?via%3Dihub">REM sleep</a>.



<h6 class="wp-block-heading" id="h-more-23andme-reports-on-sleep">More 23andMe Reports on Sleep</h6>



23andMe also offers customers various sleep-related reports. Those include wellness reports on deep sleep, sleep movement, and 23andMe+ reports (Powered by 23andMe Research) on obstructive sleep apnea and restless leg syndrome. These different sleep-related issues could affect sleep patterns and contribute to restlessness.



In 2021, during the height of the COVID pandemic, 23andMe conducted <a href="https://blog.23andme.com/articles/covid-impact-on-sleep">a sleep survey</a>, which found that the pandemic had a profound impact on sleep. It was also consistent with other published studies during the period. Another<a href="https://nutrition.bmj.com/content/4/1/132"> study published in 2021</a> noted that sleep disruption and stress among healthcare workers during the pandemic were also associated with a higher risk of infection and more severe symptoms from COVID-19. However, broad population-wide changes in sleep patterns are relatively easy to study.&nbsp;



Along with the new 23andMe+ Insomnia report (Powered by 23andMe Research), 23andMe also has a collection of other sleep-related reports. Some are included in the 23andMe+ Premium membership, such as the Obstructive Sleep Apnea and the Restless Leg Syndrome reports (Powered by 23andMe Research). But 23andMe’s Health + Ancestry Service also includes sleep-related Wellness reports, including reports on Deep Sleep, Sleep Movement, and Wake-Up Time. Each is meant to look at how your genetics may play a role in the quality of your sleep.



<h6 class="wp-block-heading" id="h-find-out-more">Find Out More</h6>



23andMe+ Premium members can click<a href="https://you.23andme.com/reports/prs.insomnia/"> here</a> if they wish to view their report.



Current 23andMe Health + Ancestry Service customers on the current genotyping chip can receive this and 35+ other reports by joining a 23andMe+ Premium membership within their account. Learn more<a href="https://you.23andme.com/subscription/"> here</a>.



Not a 23andMe+ Premium member yet? Learn more about what 23andMe has to offer<a href="https://www.23andme.com/compare-dna-tests/"> here</a>.

New Genetic Report on Insomnia

Genetic counselors are an integral part of 23andMe, including a role in helping to shape many health related reports, features and services we offer. In honor of Genetic Counselor Awareness Day we’re highlighting their role at 23andMe and the important role genetic counselors play within healthcare more broadly.



<h6 class="wp-block-heading" id="h-what-do-genetic-counselors-do">What do genetic counselors do?</h6>



Genetic counselors have specialized training and education in both medical genetics and counseling. As their professional title suggests, genetic counselors lean upon their background training in counseling skills to help people looking for support to interpret and understand their test results.&nbsp;



We are proud to have six genetic counselors in various roles at 23andMe. While 23andMe genetic counselors do not provide individual genetic counseling services to our millions of customers, they work as a team to make access to genetic information possible on a large scale.&nbsp;



The work our <a href="https://medical.23andme.com/medical-team/">Genomic Health team</a> does is diverse and supports the various <a href="https://www.23andme.com/about/">values that guide our company</a>. Some of the team focuses on 23andMe reports, creating and updating the reports that bring clear and accurate genetic information to our customers. Others provide <a href="https://blog.23andme.com/articles/genetic-report-consults?gad_source=1&amp;gclid=CjwKCAjwkY2qBhBDEiwAoQXK5aNWLlLpQjqDFuNEYPMnweywhEC0ChSUHWpa094p9AJ3BXJwIPx9WRoCyIYQAvD_BwE&amp;gclsrc=aw.ds">genetics education through learning programs for clinicians</a>, <a href="https://medical.23andme.com/pharmacogenetics-video/">informational videos</a> on genetics, and <a href="https://perspectives.nsgc.org/Article/busting-common-misconceptions-about-direct-to-consumer-genetic-testing">articles and other communications for healthcare professionals</a>.&nbsp;



<h6 class="wp-block-heading" id="h-who-are-the-genetic-counselors-at-23andme-nbsp-nbsp">Who are the genetic counselors at 23andMe?&nbsp;&nbsp;</h6>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="683" height="1024" src="http://35.88.189.111/wp-content/uploads/2023/11/Stacey-headshot-BW-683x1024.jpg" alt="" class="wp-image-32327" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/11/Stacey-headshot-BW-683x1024.jpg 683w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Stacey-headshot-BW-587x880.jpg 587w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Stacey-headshot-BW-787x1180.jpg 787w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Stacey-headshot-BW-200x300.jpg 200w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Stacey-headshot-BW-768x1152.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Stacey-headshot-BW-scaled.jpg 1706w" sizes="auto, (max-width: 683px) 100vw, 683px" /><figcaption class="wp-element-caption">Stacey Detweiler, MS, LCGC &#8211; Medical Affairs Manager</figcaption></figure>



“Making genetics accessible and paving a path towards precision medicine is an honor and a joy.”&nbsp;



Stacey joined 23andMe in 2016 as a Medical Affairs Associate and focuses on product, clinical, and educational development. She ensures our product and marketing include consumer-friendly information that’s medically accurate.



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<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="682" height="1024" src="http://35.88.189.111/wp-content/uploads/2023/11/Anne-Greb-headshot-in-black-and-white-682x1024.jpg" alt="" class="wp-image-32326" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/11/Anne-Greb-headshot-in-black-and-white-682x1024.jpg 682w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Anne-Greb-headshot-in-black-and-white-768x1153.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Anne-Greb-headshot-in-black-and-white-200x300.jpg 200w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Anne-Greb-headshot-in-black-and-white-586x880.jpg 586w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Anne-Greb-headshot-in-black-and-white-786x1180.jpg 786w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Anne-Greb-headshot-in-black-and-white-scaled.jpg 1706w" sizes="auto, (max-width: 682px) 100vw, 682px" /><figcaption class="wp-element-caption">Anne Greb, MS, CGC, 23andMe Lead, Medical Education</figcaption></figure>



“For the past three decades, I eagerly anticipated this new era of precision and genomic medicine.”



Anne joined 23andMe in 2018 and leads our Medical Education Team. She specializes in educating clinicians on how to answer questions from patients about their 23andMe reports.&nbsp;



<hr class="wp-block-separator has-alpha-channel-opacity"/>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="682" height="1024" src="http://35.88.189.111/wp-content/uploads/2023/11/Marlena-headshot-BW-682x1024.jpg" alt="" class="wp-image-32330" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/11/Marlena-headshot-BW-682x1024.jpg 682w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Marlena-headshot-BW-200x300.jpg 200w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Marlena-headshot-BW-768x1152.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Marlena-headshot-BW-586x880.jpg 586w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Marlena-headshot-BW-786x1180.jpg 786w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Marlena-headshot-BW-scaled.jpg 1706w" sizes="auto, (max-width: 682px) 100vw, 682px" /><figcaption class="wp-element-caption">Marlena Orthlieb, MGCS, LCGC &#8211; Medical Affairs Associate</figcaption></figure>



“I am thrilled that we are building unprecedented opportunities for people to access and benefit from their genome.”



Marlena joined 23andMe as a Medical Affairs Associate in 2022. Her roles are varied at 23andMe, from communication and research efforts to product and service development.&nbsp;



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<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="682" height="1024" src="http://35.88.189.111/wp-content/uploads/2023/11/Amy-Sturm-headshot-in-BW-682x1024.jpg" alt="" class="wp-image-32329" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/11/Amy-Sturm-headshot-in-BW-682x1024.jpg 682w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Amy-Sturm-headshot-in-BW-768x1153.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Amy-Sturm-headshot-in-BW-200x300.jpg 200w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Amy-Sturm-headshot-in-BW-586x880.jpg 586w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Amy-Sturm-headshot-in-BW-786x1180.jpg 786w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Amy-Sturm-headshot-in-BW-scaled.jpg 1706w" sizes="auto, (max-width: 682px) 100vw, 682px" /><figcaption class="wp-element-caption"> Amy Sturm, MS, CGC &#8211; Director of Population Health Genomics</figcaption></figure>



“I’m thrilled to help build a path for individuals on their health journey.”&nbsp;



Amy joined the 23andMe team in 2022 and is Director of Population Health Genomics at 23andMe. She provides expertise and strategic guidance across many teams at 23andMe as the company seeks to evolve and scale its health-related products and services.



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<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="683" height="1024" src="http://35.88.189.111/wp-content/uploads/2023/11/Hannah-headshot-in-BW-683x1024.jpg" alt="" class="wp-image-32332" style="aspect-ratio:1;object-fit:cover" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/11/Hannah-headshot-in-BW-683x1024.jpg 683w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Hannah-headshot-in-BW-587x880.jpg 587w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Hannah-headshot-in-BW-787x1180.jpg 787w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Hannah-headshot-in-BW-200x300.jpg 200w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Hannah-headshot-in-BW-768x1152.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Hannah-headshot-in-BW-scaled.jpg 1706w" sizes="auto, (max-width: 683px) 100vw, 683px" /><figcaption class="wp-element-caption"> Hannah Llorin, MS, LCGC &#8211; Genetic Counselor</figcaption></figure>



“I am privileged to be helping people benefit from their genetic information while integrating principles of diversity, equity and inclusivity.”



Hannah (she/her) joined 23andMe in 2023. She works to develop clinical support tools and educational resources for healthcare professionals and interacts closely with the medical team that delivers genetics-informed clinical services through the 23andMe and Lemonaid Health platforms.&nbsp;



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<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="683" height="1024" src="http://35.88.189.111/wp-content/uploads/2023/11/Brianne-headshot-in-BW-683x1024.jpg" alt="" class="wp-image-32331" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/11/Brianne-headshot-in-BW-683x1024.jpg 683w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Brianne-headshot-in-BW-200x300.jpg 200w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Brianne-headshot-in-BW-768x1151.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Brianne-headshot-in-BW-587x880.jpg 587w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Brianne-headshot-in-BW-787x1180.jpg 787w, https://blogcms.23andme.com/wp-content/uploads/2023/11/Brianne-headshot-in-BW-scaled.jpg 1708w" sizes="auto, (max-width: 683px) 100vw, 683px" /><figcaption class="wp-element-caption"> Brianne Kirkpatrick, MS, LCGC &#8211; Medical Communications Manager</figcaption></figure>



“Being a genetic counselor is not a job; it’s a way of approaching genetic information with appreciation, and respect.”



Brianne joined the Genomic Health team in 2023 as Medical Communications Manager. She leads the Genomic Health team’s communications within the company and externally with the network of providers who participate in 23andMe for Healthcare Professionals.&nbsp;



<h6 class="wp-block-heading" id="h-why-would-i-need-to-go-to-a-genetic-counselor-nbsp">Why would I need to go to a genetic counselor?&nbsp;</h6>



There are several reasons you might benefit from meeting with a genetic counselor or other healthcare professional with training in genetics–if you’re seeking to better understand a test result, for example, or have a known genetic condition in your family. You might also meet with a genetic counselor if you are planning to start a family and are concerned about an inherited condition or are working with a fertility specialist and considering genetic testing as part of the process.&nbsp;



Here are a few more reasons: If you have a family history of cancer, Alzheimer’s disease, a heart disorder, or another genetic condition, a genetic counselor may help you better understand what that specific history might mean for your own risks or for others in your family. Some people seek out genetic counseling after having a genetic test and learning that they have a genetic variant that puts them at a higher risk for a condition.&nbsp;



In all of these cases, genetic counselors can help you explore what the next steps might be for you and your family.&nbsp;



<h6 class="wp-block-heading" id="h-where-can-i-find-a-genetic-counselor-to-work-with-individually">Where can I find a genetic counselor to work with individually?</h6>



There are several resources out there for you if you might be considering or interested in working with a genetic counselor one-on-one. Our post on <a href="https://blog.23andme.com/health-traits/report-for-healthcare-provider/">sharing your 23andMe report with your healthcare provider</a> helps 23andMe customers get started on the path. Customers may also work with a clinician that delivers genetics-informed services through the 23andMe and Lemonaid Health platforms. This is a group of healthcare professionals who have received specific training to answer questions about a growing number of 23andMe reports.&nbsp;&nbsp;



Another option is to search the <a href="https://www.findageneticcounselor.com/">Find A Genetic Counselor</a> tool developed by the National Society of Genetic Counselors. There is also a directory of genetic counselors on the <a href="https://abgc.learningbuilder.com/Search/Public/MemberRole/Verification">American Board of Genetic Counseling</a> site. Finally, your doctor or other healthcare professional can assist in making a referral to a genetic counselor in your area.

Health + Traits — Page 6