‘ACHIEVING WORLD CLASS CANCER OUTCOMES’ A STRATEGY FOR ENGLAND 2015-2020 Where does genetic testing fit in this? John Renninson Clinical Lead Peninsula Cancer Alliance

• All women with non-mucinous epithelial ovarian cancer are offered testing for BRCA1/BRCA2 at the point of diagnosis.

Background 5 year plan to improve ‘the outcomes delivered by the NHS for those affected by cancer’ Strategy written by The Independent Cancer Task Force Document commissioned by NHS England, Monitor, TDA, CQC, PHE and HEE.

6 key themes Upgrade prevention and public health Achieve earlier diagnosis Patient experience is as important as outcomes Transform living with and beyond cancer Invest to maintain high quality services Overhaul commissioning and accountability

Background – Genetic testing 95 recommendations 4 Specifically related to more genetic testing 16 will require the impact of genetic testing to be considered

What will increasing testing achieve Improved knowledge of risk for patient and family Access to risk reducing treatments Reduced incidence of cancers Improved awareness improves outcomes Wider understanding of the importance of family history LWBC with better knowledge of future risks Access to targeted treatments Possible reduced use of ineffective treatments

Recommendation 36: NHS commissioners should ensure that: • All patients under the age of 50 receiving a bowel cancer diagnosis are offered a genetic test for Lynch Syndrome. • All women with non-mucinous epithelial ovarian cancer are offered testing for BRCA1/BRCA2 at the point of diagnosis. • All women under the age of 50 diagnosed with breast cancer are offered testing for BRCA1/BRCA2 at the point of diagnosis. These tests will enable any family members at high risk to be identifed and active surveillance programmes put in place. Where applicable, positive tests should guide decisions on the most clinically and cost-effective prevention interventions or treatments.

What testing is on offer in your unit? In ours Patients with NMEOC Genetic referral offered to all patients under 60 Upfront testing and referral on result for over 60 What should we all be offering? Who should be making the offer?