At the dawn of the genomic age, the narrative was one of possibility—a race to read the code of life. Thirty years later, the story has changed. The technology has matured, the costs have plummeted, and the question is no longer “Can we sequence everyone?” With uncertainties about who will pay the bill for accessible genomics testing and the effects the results may have on individuals, the question has become “Should we sequence everyone?”

This is the current state of personal genomics: ramping up to becoming a household topic yet still grappling with its own purpose. Across medicine, researchers and clinicians are evaluating how far the human genome can—and should—go in reshaping preventive care. The future of personal genomics no longer hinges on speed or scale, but on implementation an

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