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What is the Mainstreaming Cancer Genetics Programme?

The goal of this programme is to make genetic testing part of routine cancer patient care.

Knowledge of a person’s genetic make-up can be vitally helpful when treating cancer. Genetic tests can provide information about the cause of the cancer and can aid decisions about the best treatments and drugs to use.

Unfortunately, cancer genetic testing in the UK is currently very restricted. The aim of the Mainstreaming Cancer Genetics programme is to use new technologies to develop a single test that can analyse all genetic information relevant to cancer, much faster and cheaper, than current methods.

We will also develop the required clinical infrastructure so more patients can have genetic testing. We will undertake education and communication, so the benefits and implications of genetic testing in cancer patients are better recognised.

The programme will directly lead to many more cancer patients being able to benefit from genetic testing. It will lay the foundations so every cancer patient can have access to genetic testing.

The programme is being led by the Institute of Cancer Research in partnership with the Royal Marsden NHS Foundation Trust and is funded by the Wellcome Trust. The programme will run from 2013-2016.

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UK cancer genetic services support increased access to cancer gene testing

Developing the infrastructure, processes and capabilities required for cancer gene testing to become routinely available to those that can benefit is an essential component of the Mainstreaming Cancer Genetics (MCG) programme.

Today we have published a report of a national consultation which we held with senior clinical representatives from all 24 UK NHS cancer genetic services.

The report, published in Genome Medicine, makes the following key recommendations and key challenges to delivering optimal gene testing for people with cancer and their families in the UK:

Key recommendations

  1. Mainstreaming of cancer gene testing, with tests in cancer patients performed through the routine cancer patient pathway, is likely to be the optimal approach to deliver the required volume of tests.
  1. Mainstreaming should be implemented in collaboration with genetics, who should continue to see any individuals found to have mutations, and any complex cases.
  1. Nationally agreed, evidence-based, simple guidelines outlining eligibility for gene testing are required to ensure national consistency.
  1. Consistent clinical interpretation of variants is required. Improved training and support for geneticists in clinical variant interpretation together with improved automated interpretation pipelines should be developed.
  1. A sustainable model of resource allocation that promotes and supports this mainstreamed model of service delivery is required.

Key challenges identified

  1. Lack of capacity of cancer genetic services at a time of greatly increased demand for cancer gene testing from patients and clinicians.
  1. Inconsistency of services and patient management, particularly with regard to testing eligibility, risk estimation and variant interpretation practices.
  1. Education of non-geneticists to ensure appropriate information and support is provided to the patients they test.
  1. Improved education of genetic services in clinical interpretation and management of genetic variants.
  1. Sufficient and appropriately configured funding.

This national consultation with UK NHS cancer genetic services is a key component of the MCG programme’s ongoing Implementation and Education & Engagement activities, and complements previous consultations held by the programme with UK molecular genetics laboratories and UK cancer charities.

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