England’s Sally Davies wants DNA tests to be routine for cancer patients
England’s Chief Medical Officer, Professor Dame Sally Davies, said DNA tests should be routinely offered to cancer patients to help select the best treatments for them.
Dame Sally says in her annual report that the National Health Service (NHS) must deliver her “genomic dream” within five years.Dame Sally wants whole genome sequencing (WGS) to become as standard as blood tests and biopsies.
Over 31,000 NHS patients, including some with cancer, have already had their entire genetic code sequenced.
Humans have about 20,000 genes – bits of DNA code or instructions that control how our bodies work. Tiny errors in this code can lead to cancer and other illnesses. Sometimes these mistakes are inherited from a parent, but most of the time they happen in previously healthy cells.
WGS – which costs about £700 – can reveal these errors by comparing tumor and normal DNA samples from the patient. Dame Sally says that in about two-thirds of cases, this information can then improve their diagnosis and care.
Doctors can tailor treatments to the individual, picking the drugs mostly likely to be effective.WGS can also show which patients are unlikely to benefit, so they can avoid having unnecessary drugs and unpleasant side-effects.
Dame Sally wants DNA testing to become standard across cancer care, as well as some other areas of medicine, including rare diseases and infections.
“I want the NHS across the whole breadth to be offering genomic medicine – that means diagnosis of our genes – to patients where they can possibly benefit,” her report says.
People with rare diseases could benefit from having greater access to the technology, speeding up diagnosis.
Doctors are already using genetic tests to identify and better treat different strains of the infectious disease tuberculosis.
Dame Sally said patients could be assured that their genetic data would be stored securely and “de-identified” so that their privacy would be protected.
Currently, genetic testing of NHS patients in England is done at 25 regional laboratories, as well as some other small centers.
Dame Sally wants to centralize the service and set up a national network to ensure equal access to the testing across the country.A new National Genomics Board would be set up, chaired by a minister, to oversee the expansion and development of genomic services.
In an interview with a national British morning television news program, Dame Sally said that a lot of money was being spent because it was currently operating like a “cottage industry”.
By having centralized laboratories, more could be done with the money, including keeping up with the latest technology, she said.
She said one hurdle could be doctors themselves, who “don’t like change”, and she urged cancer service patients to press their doctors to move from a local to a national service.
She also said patients must understand they needed to allow use of their data, alongside other data, in order to get the best diagnosis, and therefore the best treatment.
Phil Booth, from campaigning organization Med Confidential, said the move has a“huge potential” for patients and the NHS, but there are “great risks with large collections of sensitive data”.
He said every single use of patient data must be consensual, safe and transparent, and that patients should be given the choice to opt-out if they wish to do so, he said in an interview.
