The battle against common diseases

Doctors and researchers are using high-performance technology to search for the causes of common diseases. The causes are complex but the latest scientific findings are promising.

Diagnosing and healing common diseases such as heart attack, stroke or cancer at an early stage remains a major challenge to researchers and doctors. Roughly two-thirds of all complex diseases cannot be treated causally.

Contrary to monogenic diseases, which are caused by a mutation in a single gene, common diseases confront researchers with a far more complex situation. These diseases are the result of the combined effects of several genes and environmental factors, that is to say several weak effects acting concurrently. To insurers, complex diseases are more relevant than monogenic diseases. This is because of their almost 100-fold frequency and the age at which the disease first appears in a patient.

Monogenic diseases often affect children. Persons applying for insurance are generally of an age at which most monogenic diseases already would have appeared if the insureds had had the genetic disposition. The risk of antiselection resulting from genetic testing for monogenic diseases is generally low. It is quite a different matter with complex diseases: genetics will make it possible to develop individual prevention programmes for a variety of diseases.

The opportunities this brings are tremendous: the ability to recognise those who are especially at risk and to help them make sure this risk does not develop into a disease. After all, the cost explosion in healthcare is primarily attributable to common diseases and the consequential losses arising from them.

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Identifying the causes of common diseases still very complex

It will take several decades to fully identify the causes of common diseases, for genetic research remains very complex, despite the fact that the genetic code has been cracked. Scientists have long abandoned the idea that a specific disease can be put down to a single gene.

It is now clear that strong genetic effects are the exception and exist in sub-groups (for instance, in the case of ethnic or pathophysiological [diseases]/features). This means that scientists must probe into the complicated interactions between numerous weak effects - a laborious, time- and cost-consuming process, since the influence of the individual causal factors is relatively low and thus difficult to detect.

Nevertheless, recent scientific findings give cause for hope: thanks to new methods that allow early detection and treatment, the battle is being waged with greater intensity and we hope it will ultimately be won.

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