Government strategy commits to personalising care for patients

A new government strategy setting out the future of healthcare for people in the UK, has been welcomed by Bowel Cancer UK.

The strategy, Genome UK: the future of healthcare, aims to ensure the best-personalised care is given to patients, by harnessing the power of advanced genomic medicine. It commits to a number of measures, which, when implemented, should ensure a much more tailored healthcare approach for bowel cancer patients and those who may be at risk of developing bowel cancer.

Bowel Cancer UK were invited to sit on the National Genomics Board who were responsible for shaping the report, and were able to highlight the genomic healthcare needs of bowel cancer patients, which have been reflected in the final strategy.

Among the strategy's commitments is the testing of patients for DPD deficiency. DPD deficiency can cause serious side effects and adverse reactions to certain types of chemotherapy. In a small number of cases, it can lead to death.

The strategy sets out that testing will be introduced in all four nations of the UK, identifying patients who are at increased risk from particular treatments. Routine DPD testing across the whole of the UK would reduce the numbers of bowel cancer patients who are admitted to intensive care and potentially losing their lives, by identifying those who will have an adverse reaction to treatment before it is administered.

The Government also commits to continuing to develop a public health and screening system that uses genomics to intensify screening and interventions in those at high risk.

Professor Sir Mike Richards' October 2019 Independent Review of adult screening programmes highlighted the potential that genomic techniques, including polygenic risk scores (using your genetic information to predict your risk of a particular disease), could have in targeted screening.

The strategy acknowledges that screening programmes of the future will need to be more targeted, and NHS England's Long Term Plan and the Government's Advancing our health: prevention in the 2020's green paper published in July 2019 sets out the Government's ambition to embed genomics into routine healthcare, to improve population health through disease prevention enabled by better screening. This includes the use of personalised and risk stratified screening and testing of the family members of cancer patients to identify where they are at increased risk of cancer.

Dr Lisa Wilde, Director of Research and External Affairs at Bowel Cancer UK, said: "The value of genomic medicines cannot be underestimated. It spans the entire cancer pathway – from identifying a person's risk of developing cancer, determining whether a patient has cancer due to a hereditary condition, or which treatments are safe and effective to use. Genomic medicine will help us to personalise the diagnosis, treatment, care and monitoring of people following a bowel cancer diagnosis.

"We're pleased to see the Government's commitment to harness the potential of advanced genome sequencing. In partnership with clinicians and those affected by DPD deficiency, we have worked to build the evidence base to support DPD testing across the UK and are pleased this has been reflected in the strategy.

"There are clear advantages to being able to routinely test for particular conditions, and scientific advances will help to ensure a pre-emptive approach to health through screening and interventions for those at high risk.

"Bowel cancer is the UK's second biggest cancer killer, so being able to use genomics to establish risks to individuals will make a world of difference to many, though this heavily relies on capacity and expertise being fully addressed and will a vital element to the success of the strategy."

The strategy is divided into three pillars: diagnosis and personalised medicines; prevention; and research. The strategy also identifies five cross-cutting themes that the Government will focus on alongside the three main pillars, and these are:

• Engagement and dialogue with the public, patients and the healthcare workforce

• Workforce development and engagement with genomics through training, education and new standards of care

• Supporting industrial growth in the UK, facilitating entrepreneurship and innovation for projects and companies of all sizes, through common standards, funding, procurement, and R&D structures

• Maintaining trust through strong ethical frameworks, data security, robust technical infrastructure and appropriate regulation and

• Delivering nationally coordinated approaches to data and analytics