Cross-border genetic testing is widespread, particularly for rare diseases, with over 18,000 samples crossing borders in 2002. Samples are sent abroad for tests not available locally, centralization of testing, or lower costs. However, this creates issues around quality assurance, finding high-quality labs, reimbursement policies, and data protection. Initiatives like the Genetics Quality Assurance database aim to help address these issues by providing information on lab accreditation and participation in proficiency testing.