FAQs for Patients and Healthcare Providers
- Breast Cancer ProSigna® Assay
- Non-Invasive Prenatal Testing
- Expanded Carrier Screening
- Known Mutations and Single Genes
- Genetic Testing For Breast Cancer
- Whole Exome Sequencing
- Whole Genome Sequencing
How long will the TreatGXPlus test results stay relevant? How often will I need to redo the test?
Which conditions and medications does the test include?
Can I have a sample taken for the Prosigna® test at a LifeLabs Patient Service Centre?
How accurate are Prosigna® results? How does Prosigna® compare to other commercial assay tests?
I live outside of Ontario and BC. How can I get a non-invasive prenatal test done?
Can I view my Panorama® results online?
Can an egg donor recipient have the Panorama® test done?
I forgot to check off the gender request on my Panorama® requisition. Can I still find out the gender?
How accurate is the Panorama® prenatal screening test compared to others?
I’m unsure which test details to include in my order/requisition. Can I call LifeLabs Genetics for guidance?
My report indicated that the test yielded “No Result.” What does that mean?
Can I just test for gender?
I’m already pregnant. Should my partner and I get tested at the same time?
I’m planning multiple pregnancies. If Counsyl increases the number of conditions it can detect or changes the screen in other ways, will I be eligible to receive an updated report? For my next pregnancy, will I need to take the test again to take advantages of test enhancements?
Will Counsyl Expanded Carrier Screening definitively tell me whether I will have a healthy pregnancy and a healthy baby?
Where can I find the pricing for one of these 3500+ hereditary tests?
Why should I choose the LifeLabs Genetics hereditary breast and ovarian cancer test?
Will my insurance premiums increase if my BRCA 1/2 test results are positive?
Why is the LifeLabs Genetics breast cancer test superior to other tests?
What kind of BRCA 1/2 testing does LifeLabs Genetics offer? What type of testing should I order?
Does LifeLabs Genetics report variants? Incidental findings?
How are the WES results interpreted?
Do provincial healthcare plans reimburse for WES testing? How do I get funding for the WES test?
I’m unsure which test details to include in my order/requisition. Can I call LifeLabs Genetics for guidance? What are the best options for my condition/situation?
What does it mean to test positive for a genetic disease? Can I be cured? Will I pass genetic mutations on to my kids?
I want to know the list of diseases to which I am – or my offspring are – susceptible. Can this test help me to predict and improve my health and/or the health of my baby?
Do I need to book an appointment for genetic testing?
How much does genetic testing cost?
I don’t live in Canada. Can I still take a LifeLabs Genetics test?
Do I need a referral and requisition from my physician to take a genetics test?
Can I order a genetic test for my child?
Will the test finally give me a diagnosis?
Can I find out my ancestry from LifeLabs Genetics?
What is genetic testing?
How can I pay for a test?
How do I apply for provincial funding for a test?
Are the test costs covered by provincial healthcare insurance?
How does LifeLabs Genetics keep track of my sample?
How can I order a kit, or multiple kits?
I can’t make it to one of your Patient Service Centre labs. How do I provide a sample?
Can I view my family member’s results?
Are my personal health information and test results secure?
How are results provided?
Are there any time limits on getting my sample to LifeLabs Genetics? Do the forms, kits, or samples “expire”?
Can I use a courier or Canada Post to ship my sample?
Can I drop my sample off at your lab?
There are two parts to this test: your pharmacogenetic information and access to the online decision support tool. Your genetic results do not change and are likely to be useful for your entire life. However, due to the anticipated continuous advancement in the burgeoning field of pharmacogenetics, the test and online decision support tool will be updated periodically so make sure to login whenever you or your physician feel there is a need to modify or adjust your treatment plan.Print this Answer
Check out the drug and condition search tool in the test details section to find out if there is a known genetic marker that impacts your metabolism or response to your medications. Also download a full list of medications supported by TreatGxPlus service.Print this Answer
No. Prosigna® requires a tumour tissue (histology) sample from your physician or hospital.
This type of sample is usually obtained during surgery. If you and your physician are considering this test, you must request the sample prior to your surgery. Some hospital pathology labs keep post-surgical samples on “file.” Your physician may be able to submit one of these samples for Prosigna.Print this Answer
Prosigna has proven prognostic significance in two clinical studies with more than 2,400 patients. One of these studies, the TransATAC study, compared Prosigna® with other commercial assay tests and found the following:
“For post-menopausal women with node-negative, hormone receptor-positive, HER2-negative early stage breast cancer, the study found that Prosigna® provided the most accurate prognostic information of all four multigene expression profiles tested as measured by the statistical measure known as the likelihood ratio. The study further found that Prosigna® also provided the most accurate differentiation between low and high risk patients as compared to the other genomic tests. Low-risk women as identified by Prosigna® had a 3% risk of DR [distant recurrence] over 10 years, the lowest rates of DR for all genomic tests that were studied. In contrast, high risk women as identified by Prosigna® had on average a 33% chance of distant recurrence by 10 years.”
http://investors.nanostring.com/releasedetail.cfm?releaseid=1003666Print this Answer
Contact us, and we can send a kit to you. The kit includes all paperwork and tubes required for you to get your sample drawn.Print this Answer
No. You can receive your results only from your physician.Print this Answer
No. Panorama® is not appropriate for egg donors.Print this Answer
Yes. Your physician needs to fill out our change authorization form. Once we receive that, we can send the physician an amended report.Print this Answer
Studies* indicate that Panorama® identifies Trisomy 21 (Down Syndrome) and Trisomy 13 (Patau Syndrome) with >99% sensitivity and false-positive rates of 0%, while another popular test reports sensitivities of, respectively, 79% and 50% with 5% and 0.3% false-positive rates.
Panorama® has a >96% detection rate for Trisomy 18, with a false positive rate of <0.1%, while that same competing test has 80% sensitivity and a 0.3% false positive rate.
Panorama® screens for Monosomy X (Turner Syndrome), triploidy, fetal sex, and optional microdeletion syndromes while the other popular test does not screen for these conditions at all.
Panorama® is the superior option.
*See http://www.panoramatest.com/panorama-test/clinical-information for the list of studies.Print this Answer
With single or multiple sample testing, fetal sex, and several microdeletion options, it can be challenging to pick the right version of the Panorama® test. Yes, please speak with your physician and/or contact us for ordering assistance. Please note that the test is not appropriate for surrogates, women using donor egg, bone marrow transplant patients, or those carrying twins (or more).Print this Answer
A “No Result” report can occur for many, many reasons and, generally, there is no need to worry. The result may be due to low fetal fraction (i.e., when there is not enough of the baby’s DNA in the mother’s blood sample).
Biological differences, higher body mass indexes (BMIs), mishandled or poorly prepared samples, and other conditions sometimes also necessitate new blood samples (redraws). In the rare case where even a redraw/resample is not able to provide a meaningful result, LifeLabs Genetics will contact you with an explanation and will reimburse you for the cost of the test.Print this Answer
No. You need to order the Panorama® test to receive a gender requestPrint this Answer
With this expanded carrier screen, you and your partner have the option to take the test independently (i.e., at different times) or at the same time. If you are already pregnant,taking the test together may allow for more time for planning, decision making, additional testing, and early intervention, if necessary.Print this Answer
Counsyl occasionally adds new, detectable conditions to the test protocol and additional details to its reports. If Counsyl makes enhancements to the test during the gap(s) between pregnancies and you want to take advantage of those enhancements, you will have to pay for and take the test again. Neither Counsyl nor LifeLabs Genetics keeps your sample on file for future test reruns.Print this Answer
No genetic test can provide a 100% guarantee that you will have a healthy pregnancy and a healthy baby. Counsyl is a carrier screen for 175 different genetic conditions. The screen can identify over 99% of possible mutations in most of the genes screened, but it does not rule out all possible conditions.Print this Answer
The LifeLabs Genetics Search for a Test feature allows you to enter the disease, gene, or panel of interest to get pricing, sample kit, requisition forms, and other ordering details.Print this Answer
The LifeLabs Genetics BRCA1/2 test balances thoroughness with cost-effectiveness, speed, and usefulness and includes pre and post test genetic counselling. Our test focuses on two well understood and documented genes – BRCA1 and BRCA2 – to provide scientifically sound results with useful recommendations. An experienced, in-house geneticist and our genetic counsellors reviews family history details, interprets the test results, and makes recommendations on whether further testing is required. Combining test data and expert, objective interpretation with your physician’s knowledge of your goals and health status provides high quality, actionable insights.
An alternative to BRCA1/2 is an expanded gene panel (example: > looking at 20 genes at once) to flag any predisposition to cancer. LifeLabs genetics does offer expanded gene panels for hereditary cancer testing; however we believe that these type of panels are best ordered by genetic specialists in cancer genetics clinics after careful clinical assessment particularly when there is a complex medical and/or family history. These genetic specialists take into account important consideration, for example whetherexamining additional genes could reveal other genetic variants that might obscure definitive conclusions, results could possibly yield false-positives for extremely rare diseases, and results could indicate clinically insignificant risks due to limited research and current follow-up options.
Please contact us with any questions you may have.Print this Answer
The CanadinaGovernment recently passed Bill S-201 (a Canndian equivalent to the U.S. Genetic Information Nondiscrimination Act (GINA)). The bill states that it is unlawful to engage in genetic discrimination and prohibits companies requiring the disclosure of genetic testing results before providing goods or services or entering into a contract. LifeLabs Genetics never releases results to anyone other than the ordering physician. However, insurance companies categorize people according to the amount of risk they pose and charge different premiums based on those levels of risk. Insurance policy application forms may still include questions about your health, family history, age, occupation, etc. When those details are entered into an actuarial table, it may become evident that you are in a higher risk category based on your family historyPrint this Answer
The LifeLabs Genetics test balances thoroughness with cost-effectiveness, speed, and usefulness. Our test focuses on two well understood and documented genes – BRCA 1 and BRCA 2 – to provide scientifically sound results with useful recommendations. An experienced, in-house geneticist reviews family history details, interprets the test results, and makes recommendations on whether further testing is required. Combining test data and expert, objective interpretation with your physician’s knowledge of your goals and health status provides high quality, actionable insights.
A competitor to our BRCA 1/2 test examines 27 genes to flag any predisposition to cancer; however, examining additional genes usually reveals numerous genetic variants that can obscure definitive conclusions, yield false-positives for extremely rare diseases, and indicate clinically insignificant risks. Based on our current understanding of genetics today, having more data to work with is not necessarily better — in some cases, additional data makes moving forward more confusing. The LifeLabs Genetics BRCA 1/2, as a screen, provides all the information that you need to know to move forward.
The LifeLabs Genetics BRCA 1/2 test package includes genetic counselling. Please contact us with any questions you may have.Print this Answer
LifeLabs Genetics performs BRCA 1/2 testing basically in the same way as other types of hereditary conditions testing. We offer the following for BRCA1/2 analysis:
- Next generation sequencing (NGS): sensitivity >98.5%, specificity >98.2%, 100% coverage >20x
- Deletion/duplication via MLPA: sensitivity 99.9% and specificity 99.8%
- Sanger sequencing and familial mutation testing also available
Genetic testing is often compared to visiting a bookstore or a library. Perhaps that comparison may shed light on which type of BRCA 1/2 test to order:
- Sequencing looks at the entire gene, from beginning to end, to identify obvious and more subtle genetic mutations or variations. If a gene were a chapter in a book, sequencing could reveal a previously undetected, single-letter spelling mistake.
- Deletion/duplication, or multiplex ligation-dependent probe amplification (MLPA), looks for “larger pieces” of missing genetic information or extra, duplicated portions of the gene. If a gene were a book chapter, deletion/duplication testing could find the missing paragraph or pages. Deletion/duplication testing could also flag where a paragraph has been erroneously added multiple times to a book.
- Family mutation testing uses previously identified genetic mutations and familial hereditary patterns to pinpoint and examine a precise spot on a person’s genome. Family mutation testing confirms or rules out whether you have the same variation on the same gene as a family member. So, when comparing a gene to a book chapter, family mutation testing could find a specific quotation within the book. This type of testing is quite quick because you know exactly where in the book to look and do not have to read the whole chapter.
Genetic sequencing and deletion/duplication testing are normally ordered together for the most complete results.
Please speak with your physician and/or contact us if you have any questions about what to order.Print this Answer
All disease-causing variants relating to the phenotype reported in HGMD®, ClinVar and CentoMD® (classes 1 and 2), as well as all variants with minor allele frequency of less than 1% in the ExAC database are considered in the medical interpretation. Class 1, 2, and 3 variants are evaluated. Variants that possibly impair the protein sequence are prioritized. All relevant inheritance patterns are considered based on the family history and clinical information submitted with the sample(s). CENTOGENE continuously assesses variants as new information becomes available internally and in the medical literature. When familial studies are recommended, familial variant testing is available for a small fee.
LifeLabs Genetics and CENTOGENE adhere to the “ACMG Recommendations for Reporting of Incidental Findings” and will not report on incidental findings that are not listed in these guidelines. However, it does mean that we will report variants detected in certain genes or classes of genes that are outlined in these recommendations as being medically actionable. Patients who prefer not to receive this information in their report, can opt out of this service. In case of Trio analyses, incidental findings are only analysed for the index patient. Carrier information of the parents for identified incidental findings of the index can be requested with new consent from the parents. Findings will be issued on individual reports. Incidental findings are not reported for fetal samples or samples from deceased persons.Print this Answer
When you purchase a WES package from LifeLabs Genetics, you get sequencing of all exons, end-to-end bioinformatics analysis of raw data, validation or sequencing results, extensive and detailed reports, and access to the raw data. Each WES diagnostic report is validated by CENTOGENE’s team of renowned and experienced clinical specialists and cross-referenced against any family information provided as well as the CentoMD® mutation database. LifeLabs Genetics’ counsellors will also review, interpret, and speak with your physician when unexpected results are found.Print this Answer
Depending on your province of residence, ministry of health coverage could be available. It is always best to first discuss this type of funding with your physician—a referral to a genetics (or other) specialist may be required.
In some provinces, WES test costs are reimbursed only when ordered by a qualified geneticist. This is usually the case in Ontario, for example. Once the geneticist gains approval via a Ministry of Health and Long-Term Care letter, he/she can attach the Ministry’s approval letter to the requisition.Print this Answer
With different coverage depth, analysis types, turnaround time, and sampling (trio vs. single) options, it can be challenging to pick the right version of the WES test for you. Yes, please speak with your physician and/or contact us for ordering assistance to increase your chances of obtaining the specific information that you are looking for.Print this Answer
Genetic testing identifies whether you have a specific genetic mutation. It can also predict the likelihood of you passing on a disease-causing mutation to your children.
A positive result does not a guarantee that you, or your children, will develop a genetic disease. Other health, lifestyle, environmental, and genetic factors may play a role in influencing whether, or how, the disease develops.
We do know that, at this point, the vast majority of genetic diseases cannot be cured. However, depending on what the disease is, interesting and helpful options to prevent and manage genetic disease are emerging daily.Print this Answer
The WGS test is intended for individuals with serious, legitimate medical concerns, especially those who need a speedy diagnosis for a rare disease.
The WGS test can provide so much information that it can be overwhelming – sometimes the information can even be contradictory given our current understanding of the human genome. It is a medical-grade test that is really most valuable when a physician or genetic specialist is looking to understand more about a specific, unusual disease or condition. Please contact us to determine whether LifeLabs Genetics offers a genetic test that fulfils your needs.Print this Answer
No. You can go to any LifeLabs Patient Service Centre and have the sample drawn with or without an appointment. Self-collection is available for some tests (e.g., Counsyl).Print this Answer
There are many different genetic tests available. Please discuss with your physician which test is appropriate for you. Visit our website at http://lifelabsgenetics.com/genetics-search to search for the test you are taking, and there you will find pricing, turnaround times, requisitions, and consent forms.Print this Answer
No, unfortunately not. LifeLabs Genetics has obtained certifications and licenses for Canadian laboratory testing only. If you would like to contact us, we can provide testing suggestions for your country of residence.Print this Answer
Yes. LifeLabs Genetics provides clinical, medical-grade genetic testing. We conduct tests only under the guidance of a healthcare provider. For any genetic test ordered at LifeLabs, we require a physician to complete and sign a requisition.Print this Answer
There are no age limits on genetic testing. However, we do not recommend predictive genetic testing (e.g., BRCA 1/2) for children unless advised by your physician. Children should be given the right to make a decision about whether they want to find out their risks and illness susceptibility when they come of age. Many genetic illnesses have no known cure, and knowing too much may have impacts on their life choices. If possible, delay discussions about genetic testing until the child comes of age.Print this Answer
No genetic test can provide a definitive diagnosis on its own. Test results must be interpreted in the context of your entire health status and history.Print this Answer
No. LifeLabs Genetics provides clinical, medical-grade genetic testing to assist with the diagnosis, treatment, prevention, and prediction of genetic diseases.Print this Answer
Genetic testing extracts and analyzes DNA from blood, saliva, cheek cells, or tissue samples in a laboratory setting to look for gene variations, mutations, duplications, and deletions that may cause diseases. Comparing a patient’s unique genetic composition to that of a family member, a spouse/partner, or to a database can help healthcare providers to diagnose, predict, and treat inherited conditions in a patient or his/her offspring.Print this Answer
All tests are available on a private-pay basis. You can purchase a test:
Through this website, with a credit card (i.e., VISA or MasterCard).
For residents of Ontario and BC, at a LifeLabs Patient Service Centre, with cash, debit, cheque, VISA, or MasterCard.
For those outside of Ontario and BC, with a payment form (see the specific test page for details) and a credit card.
Depending on your situation and province of residence, you may be eligible for provincial healthcare insurance coverage.Print this Answer
Your healthcare provider(s) must complete a specific funding application form, send it to the ministry of health for your province, wait for a response (letter) from the ministry and, if approved, must attach a copy of that approval to the requisition form.Print this Answer
Depending on your situation, the test, and your province of residence, you may be eligible for provincial healthcare insurance coverage. Please visit a specific test page for details or contact us.Print this Answer
LifeLabs has a computer system that creates a unique patient identifier, usually based on your health card number. Once your sample is received at our lab or Patient Service Centre, we attach barcode stickers with this unique identifier to all paperwork and tubes/vials. This unique identifier can also be used to cross-reference test samples from your family members, if you have ordered a test that analyzes their samples as well. Barcode scanning ensures your name, specimen, and results are accurately matched through the entire testing process.Print this Answer
Generally speaking, healthcare providers and clinics do most of the kit ordering. Click here for details.
We can provide kits directly to patients for certain tests. Contact us for details.Print this Answer
You or your healthcare provider can order a kit for sample collection. Some kits enable self-collection, but most require professional assistance. With a kit, your healthcare provider can draw/take the sample for you or perhaps make arrangements at a nearby lab. For certain tests (e.g., Counsyl and Panorama®), LifeLabs Genetics has made arrangements with third-party labs in other provinces, such as:
- Quebec – Biron Laboratoire Médical
- Manitoba – Diagnostic Services Manitoba (DSM)
- Alberta – DynaLIFE and Calgary Lab Services
Contact us for a full list of alternative labs/collection centres.
All kits submitted to LifeLabs Genetics must include a requisition form signed by your healthcare provider.
No, not without permission from the patient. LifeLabs Genetics shares test results only with the physician who ordered the test (i.e., signed the requisition). Generally speaking, it is up to the patient, or his/her legal caregiver or guardian, to decide who has access to the results after the physician provides them.Print this Answer
The privacy, security, and confidentiality of your personal information and biological samples are maintained at every step of the process. At LifeLabs, protecting the privacy and security of personal information is essential and is fundamental to our values and to the way we do business. Feel free to peruse the LifeLabs Privacy Statement for more information.Print this Answer
When your results are ready, a LifeLabs team member will fax them to your physician. Alternatively, if there’s an online portal for the test you’ve taken, your physician will receive an email indicating that results are ready for viewing on the password-protected, secure online portal. Results are shared only with the ordering physician. We do not release results to patients or their family members.Print this Answer
Signed requisition forms should be used within six months. After six months, you may be asked to obtain another signed form. Genetic test kits, which includes paperwork and tubes/vials, have best before dates. For more accurate results, obtain a signed requisition, provide a sample in a fresh kit according to the instructions, and ensure the sample is shipped to the lab (with the signed paperwork) on the same day it is collected.Print this Answer
To ensure samples are handled with care, LifeLabs uses its proprietary, internal courier service to transport samples between Patient Service Centres and the lab. If you do not plan to visit a Patient Service Centre, we recommend FedEx, which is included in the cost of the test, if you use the LifeLabs FedEx account number. (Contact us to obtain the LifeLabs FedEx account number.)Print this Answer