Bringing genomics into an early diagnosis and risk-based cancer care system
One of the most significant shifts in the plan is the move toward earlier, more proactive detection of cancer with genomics at the centre of this plan.
Routine testing for conditions such as Lynch syndrome, as well as expanded BRCA testing for breast and ovarian cancers, will help identify people at higher inherited risk earlier and ensure they can access appropriate surveillance and support. We have already led the way in this space, working alongside the North-West GMS to deliver the Jewish BRCA programme, the first national population-wide genetic screening programme delivered with the NHS.
We also work closely with our academic partners to understand how cutting-edge genomic risk models can be integrated into NHS pathways to identify high-risk populations which will become increasingly important in the new National Cancer Plan.
In North Thames, we already work closely with Trusts and Cancer Alliances to support consistent uptake of these tests and to make pathways as straightforward as possible for both clinicians and patients. The plan’s emphasis on improving turnaround times and simplifying consent processes will help ensure these tests are clinically useful at the point decisions are made.
Genomics and targeted cancer treatments
The national plan acknowledges that genomic testing enables the NHS to deliver the most effective treatments to patients from the start of their journey.
Within the plan, genomic testing will become a routine and timely part of treatment planning, with every cancer patient able to access full genomic analysis if they choose. Crucially, results will be returned quickly enough to inform treatment decisions when they matter most.
We are already seeing the power targeted treatments, identified through genomic testing, can have on patients. In 2024, after over 20-years of research, the first ever targeted treatment for children with brain tumours was approved for use in the NHS offering some patients access to a treatment that is more effective than traditional chemotherapy with far fewer side effects.
Integrating new genomic technologies into the NHS
Genomic testing is increasingly shaping how treatment is selected and monitored.
The plan highlights the expanding use of circulating tumour DNA (ctDNA) and broader molecular profiling to guide treatment choices more quickly and with less reliance on invasive procedures. We successfully co-led the national ctDNA pilot programme that has led to the first ever national use of ctDNA testing for lung and breast cancer.
Through our work co-leading the Circulating Biomarker Network of Excellence, we are gathering evidence for further use cases of this revolutionary type of testing within cancer pathways in the NHS. Our partnership with Health Economists at Edge Health, have enabled us to not only provide clinical evidence but identify financial benefits to this new testing methodology.
Ensuring children and young people benefit equally
The plan places strong emphasis on improving cancer diagnosis and treatment for children and young people.
Whole Genome Sequencing is already available to all children with cancer, but the plan’s commitment to improving turnaround times and strengthening inherited cancer pathways for younger patients will help ensure that genomic information truly informs care when it is most needed.
Research from across the North Thames and East GMS’ highlights when children have access to this vital sequencing, 7% will gain an immediate insight that shapes their care and for almost 30% the data provides additional information that guides future treatment decisions.
North Thames clinicians play a key role in national working groups on paediatric genomics, and we welcome the greater alignment between paediatric oncology, genomics and specialist services that this plan promotes.
Improving access and participation in clinical trials
A more consistent approach to genomic testing also opens the door to clinical trials for more patients.
The proposed Cancer Trials Accelerator Programme and improved national data infrastructure should make it easier to match patients to the right trials earlier in their pathway. For our region, home to major academic centres and research hospitals, clearer processes and better data interoperability will help us support trial recruitment more effectively and reduce variation in access across the country.
A partnership approach to implementation
Perhaps most importantly, the plan recognises that genomics cannot be delivered in isolation. It requires close collaboration across diagnostic services, Cancer Alliances, clinical teams, digital teams and primary care.
Genomics is not a silver bullet, but it is an increasingly important tool in delivering more personalised, timely and effective cancer care. The plan provides a strong national framework, and our role in North Thames will be to ensure that its ambitions translate into practical improvements for patients across our region.
If we continue working collaboratively across trusts, specialties and disciplines, we can make genomic medicine a routine, reliable part of cancer care for everyone who needs it.
