You can order many of the same tests as your physician by going to a lab that accepts self-referred patients or by ordering a kit online and sending in a sample. In many cases they are the same or similar to doctors' versions and they are generally analyzed by qualified professionals. But cutting out the middleman—in this case, your health-care-provider—has drawbacks.
Even if you manage to decipher the results based on material provided by the lab or through your own research, a full interpretation often requires a medical history and physical exam. For example, one Web site touts its home test kit for C-reactive protein (a marker of inflammation) as a tool for early detection of heart disease. But the American Heart Association recommends the test only for people at moderate risk of heart disease, when an elevated level might tip the scales in favor of more aggressive treatment. And determining your coronary risk requires a thorough exam by your doctor.
Out-of-context testing can also lead to unnecessary anxiety, further tests, and unwarranted treatment. For example, the CA-125 test for ovarian cancer is a poor screening tool when used by itself. And the prostate-specific antigen test to detect prostate cancer can be abnormally high for several reasons, most of them not life-threatening.
But self-referred testing might be worthwhile when privacy is an issue, such as for people who live in states that do not guarantee anonymity for HIV test results. While our consultants still prefer face-to-face counseling for those undergoing HIV testing, the only FDA-approved home version, the Home Access HIV test, is as accurate as tests done in a doctor's office. Positive results are automatically retested, and you can phone in anonymously for results and medical and social-service referrals.
You could also consider direct-access testing if it will save you money or if you are in a particular rush to get the results. But even then, limit the tests to those recommended by your health-care provider, and make sure that the lab sends copies of the results to your doctor.
