1. Reporting
Sandi Deans and Jane Moorhead

2. Integrated Reporting for Cancer

3. Complexity Acknowledge differences between cancer and RD
Complex pathways already in place
Work with existing pathways
Potential for multiple reports at different times and in different databases/LIMS

4. Current Situation
Oncologists need an integrated report with all information when seeing patient
Example 1, receptor status for breast cancer
Example 2, EGFR, ALK, ROS1 etc for lung cancer
Holistic information on tumour essential
Additional testing may impact actual diagnosis eg new WHO classification for CNS
Potential for errors if all data not incorporated

5. "Standards for integrated reporting in cellular pathology"
RCPath document
Comments from:
UKNEQAS
BIVDA
ABPI
RCS
RCP

6. Genomic Testing for Cancer
Should follow these guidelines
Should follow the above examples ideally

7. Pathway MTB discussion initially
Summary report added to pathology report and included on EPR
Discussion at relevant cancer MDM
Co-ordinators add cases to their lists
Allows input from all relevant professionals

8. Advantages of this Approach
Safety
Obviates need to find clinician/s to receive reports
Incorporated into current pathways
All staff groups exposed to genomics etc
Cancer MDMs across country become world leaders in the field (genomics and precision medicine)

9. Downstream Copy of MDM outcomes or letter to GP currently
Keeps this pathway for genomics also
Copy of this to the patient also?
Allows for reassurance that all results reviewed

10. Feedback Received
On a practical level where a 100kGP report is shared with the originating Pathology lab (which is highly desirable) and the 100kGP report is integrated into the Pathology record (which is highly desirable), how can the GMC ‘…ensure that the genomic test result is not misreported or open to misinterpretation when integrated’. Without inspecting the integrated report in all cases?