Development of cancer genetic services in the UK: A national consultation.
BACKGROUND
Technological advances in DNA sequencing have made gene testing fast and affordable, but there are challenges to the translation of these improvements for patient benefit. The Mainstreaming Cancer Genetics (MCG) programme is exploiting advances in DNA sequencing to develop the infrastructure, processes and capabilities required for cancer gene testing to become routinely available to all those that can benefit.


METHODS
The MCG programme held a consultation day to discuss the development of cancer genetics with senior representation from all 24 UK cancer genetic centres. The current service landscape and capacity for expansion was assessed through structured questionnaires. Workshop discussion addressed the opportunities and challenges to increasing cancer gene testing in the National Health Service (NHS).


RESULTS
Services vary with respect to population served and models of service delivery, and with respect to methods and thresholds for determining risk and testing eligibility. Almost all centres want to offer more cancer gene testing (82%) and reported increasing demand for testing from non-genetic clinical colleagues (92%). Reported challenges to increasing testing include the complexity of interpreting the resulting genetic data (79%), the level of funding and complexity of commissioning (67%), the limited capacity of current processes and cross-disciplinary relationships (38%), and workforce education (29%).


CONCLUSIONS
Priorities to address include the development and evaluation of models of increasing access to gene testing, the optimal process for interpretation of large-scale genetic data, implementation of appropriate commissioning and funding processes, and achieving national consistency. The UK cancer genetics community have high expertise and strong commitment to maximising scientific advances for improved patient benefit and should be pivotally involved in the implementation of increased cancer gene testing.
The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG UK ; The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK ; Centre for Personalised Medicine, Wellcome Trust Centre for Human Genetics, St Anne's College, University of Oxford, Oxford, OX2 6HS UK.
Ingrid
I
Slade
The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG UK.
Daniel
D
Riddell
The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG UK ; Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT UK.
Clare
C
Turnbull
The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG UK ; Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT UK.
Helen
H
Hanson
The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG UK ; Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT UK.
Nazneen
N
Rahman