1. ‘ACHIEVING WORLD CLASS CANCER OUTCOMES’
A STRATEGY FOR ENGLAND
Where does genetic testing fit in this?
John Renninson
Clinical Lead Peninsula Cancer Alliance

2. • All women with non-mucinous epithelial ovarian cancer are offered testing for BRCA1/BRCA2 at the point of diagnosis.

3. Background
5 year plan to improve ‘the outcomes delivered by the NHS for those affected by cancer’
Strategy written by The Independent Cancer Task Force
Document commissioned by NHS England, Monitor, TDA, CQC, PHE and HEE.

4. 6 key themes Upgrade prevention and public health
Achieve earlier diagnosis
Patient experience is as important as outcomes
Transform living with and beyond cancer
Invest to maintain high quality services
Overhaul commissioning and accountability

5. Background – Genetic testing
95 recommendations
4 Specifically related to more genetic testing
16 will require the impact of genetic testing to be considered

6. What will increasing testing achieve
Improved knowledge of risk for patient and family
Access to risk reducing treatments
Reduced incidence of cancers
Improved awareness improves outcomes
Wider understanding of the importance of family history
LWBC with better knowledge of future risks
Access to targeted treatments
Possible reduced use of ineffective treatments

7. Recommendation 36:
NHS commissioners should ensure that: • All patients under the age of 50 receiving a bowel cancer diagnosis are offered a genetic test for Lynch Syndrome. • All women with non-mucinous epithelial ovarian cancer are offered testing for BRCA1/BRCA2 at the point of diagnosis. • All women under the age of 50 diagnosed with breast cancer are offered testing for BRCA1/BRCA2 at the point of diagnosis. These tests will enable any family members at high risk to be identifed and active surveillance programmes put in place. Where applicable, positive tests should guide decisions on the most clinically and cost-effective prevention interventions or treatments.

8. What testing is on offer in your unit?
In ours
Patients with NMEOC
Genetic referral offered to all patients under 60
Upfront testing and referral on result for over 60
What should we all be offering?
Who should be making the offer?