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Dates: 2005-2008
Funding: Department of Health
Collaborators: Wellcome Trust Centre for Human Genetics, Oxford; All-Wales Laboratory Genetics Service, Cardiff; Cancer Research UK, London; West Midlands Regional Genetics Laboratory
Information: Sarah Wordsworth and James Buchanan

Somatic mutations (non-inherited mutations in cancers) are likely to be the main determinants of how cancers behave and respond to treatment. Thus, identifying these mutations and their effects is a powerful way of optimising cancer therapy and indicating disease prognosis. Despite this, very limited molecular testing of cancers currently occurs in the UK. Testing which does occur (for example, Her2/Neu in some breast cancers and cytogenetics of some haematological malignancies) has been successful in indicating prognosis and, to some extent, tailoring treatment to individual patients.

This project aims to assess the feasibility of widespread testing of tumours in clinical practice, in terms of the scientific evidence, determinants of demand, likely impact on patient care and NHS resources. The work has five main objectives:

  • review the economic evidence for molecular (DNA and RNA-based) determinants of outcome and response to therapy in the most common cancers (breast, lung, colorectal, prostate);
  • determine the current level of somatic testing in the UK and explore the views of laboratory staff and clinicians on future testing;
  • establish how patients could, in principle, benefit from molecular testing of their tumours including information on treatment prognosis;
  • determine GP and patients attitudes to the potential benefits (and dis-benefits) of the information provided by molecular cancer testing, using discrete choice experiments (DCEs).
  • formally model the costs of service delivery in relation to the benefits which would be derived.


Wordsworth, S, Buchanan, J, Papanicolas I, Taylor, J, Frayling, I and Tomlinson, I (2008). Molecular Testing for Somatic Mutations in Common Cancers: The Views of UK Oncologists. Journal of Clinical Pathology, 61:761-765.

Wordsworth, S, Papanicolas, I, Buchanan, J, Frayling, I, Taylor, J, and Tomlinson, I (2008). Molecular Testing for Somatic Cancer Mutations: a survey of current and future testing in UK laboratories. Journal of Clinical Pathology, 2008(61):373-76.