Delays to genomic test results for lung cancer patients ‘unacceptable’ say Cambridge experts

Delays in confirming genomic test results are holding up the start of the best treatment option for thousands of lung patients, Cambridge experts warned this week.

One professor described the situation as “wholly unacceptable” as a report was published exploring the issues - including that some lab samples are being sent by second-class post.

Published by The UK Lung Cancer Coalition on Tuesday (4 March), the report details how most of the people it interviewed said there was a two to four-week wait for genomic test results. The maximum recommended turnaround time is 14 days.

Genomic tests are now a critical part of the lung cancer diagnostic and treatment pathway, helping to define the molecular make-up of tumours so that the most effective, personalised treatment can be delivered for a patient’s specific lung cancer type, increasing their chance of survival.

About 30,000 lung cancer patients a year have tissue samples sent for genomic testing.

According to a recent Darzi review, less than two-thirds (60 per cent) of genomic tests are delivered on time in England.

“This is wholly unacceptable, causing significant physical and mental harm to patients, who, having already received their devastating diagnosis, then have to endure prolonged waits before starting the treatment best suited to them,” says UKLCC’s clinical lead, Robert Rintoul, a professor of thoracic oncology at the University of Cambridge and honorary consultant respiratory physician at Royal Papworth Hospital. “Lung cancer is a rapidly fatal disease so speedy access to test results and the most effective treatments is vital.

“Faster genomic testing can streamline the patient’s journey, avoid less-effective treatments and ultimately save costs for the NHS.”

The report, titled ‘Faster Testing, Better Outcomes: Genomic Testing in Lung Cancer’, demands faster turnaround times and identifies the cause of delays.

Issues include:

- A lack of published turnaround time data across genomic laboratory hubs (GLHs); Inconsistent tissue sample quality;
- Non-uniform results reporting;
- Inadequate IT systems;
- Staffing shortages in laboratories; and
- Inefficient sample transportation, with some tissue samples being sent to labs for analysis by second-class post.

Offering some practical solutions for timely, accurate and high-quality genomic test results across the UK, and examples of where processes are working well, the report recommends:

- Regular collection and national publication of genomic testing turnaround times by the four UK health administrations;
- A named individual responsible for overseeing the entire testing pathway;
- Genomic labs should operate a seven-day working model and greater training places for healthcare scientists should be provided;
- A single digital tracking system for patient samples to monitor their journey;
- Standardised reporting templates for genomics to improve report clarity and understanding;
- A single online platform for rapid submission and receipt of results; and
- Giving patients and families access to appropriate information regarding pathology and genomic testing.

Nearly 35,000 people die each year from lung cancer, making it the UK’s biggest cancer killer. It accounts for one in five of all UK cancer deaths (21 per cent) and even in people who have never smoked it is the eighth most common cause of cancer-related death in the UK.

The UK lung cancer survival rate over five years is 16.2 per cent, which compares poorly with comparable European countries.

The disease can be cured if diagnosed early enough, but in England 35 per cent of people with lung cancer are diagnosed by emergency admission to hospital.

“No one diagnosed with lung cancer should wait more than 14 days for genomic test results,” added Dr David Gilligan, consultant clinical oncologist at Cambridge University Hospitals and Royal Papworth Hospitals and chair of the UKLCC: “We owe it to our patients to ensure that they receive the most appropriate and effective treatment as swiftly as possible.”

The full report can be read at uklcc.org.uk/our-reports.