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FOI Request

Disclosure ID
FOI/02119
Request Date
January 3, 2018
Subject
Lynch Syndrome - Colorectal Cancer
Description

FOI questions

  1. Do you test newly diagnosed bowel cancer patients in your trust (either contracted or referred) for molecular features of Lynch syndrome using either immunohistochemistry or microsatellite instability testing?
  • Yes – all bowel cancer patients, as per DG 27 NICE guidance
  • Yes – everyone under the age of 70
  • Yes – everyone under the age of 50
  • Yes – according to family history of the disease
  • No
  • Other
  1. If yes, at what stage does this testing take place?
  • Pre-treatment i.e. at diagnosis (on a biopsy of the tumour)
  • Post treatment i.e. test is carried out on the tumour resection specimen only.
  • Not applicable
  1. Is this test carried out as a reflex test i.e. automatically or upon referral?
  • Reflex
  • Referral via MDT
  • Referral via Genetics Centre
  • Referral via GP
  • Other (please explain)
  • Not applicable
  1. In their published adoption support resource NICE suggest identifying a named ‘clinical champion’ within each colorectal multidisciplinary team to effectively implement testing people for molecular features for Lynch syndrome. Is this established in your trust?
  • Yes, Gastroenterologist
  • Yes, Colorectal Surgeon
  • Yes, Oncologist
  • Yes, Clinical Geneticist
  • Other (please explain)
  • No
  1. Do you audit diagnostic outcomes within your trust to ensure that every patient is tested for molecular features for Lynch syndrome?
  • Yes, as part of private audit
  • Yes, and the data is publicly released
  • No
  1. Have you had to submit a business case for funding in order to effectively implement this new guidance?
  • Yes, and additional funding was provided fully/partially as requested. Please provide information.
  • Yes, but no additional funding was provided. Please provide information on why.
  • No please provide information on why.
  1. If no such testing is in place, do you have information on whether there are any plans to introduce molecular testing for Lynch syndrome as per NICE guidance?
  2. What are the main barriers you have faced if no molecular testing or only selected testing is performed? Please specify.
  • Financial
  • Policy
  • Awareness of current guidance
  • Staff resources
  • Other (please specify)
Response
    • Yes – all bowel cancer patients, as per DG 27 NICE guidance
    • Yes – everyone under the age of 70
    • Yes – everyone under the age of 50
    • Yes – according to family history of the disease
  1. If yes, at what stage does this testing take place?
    • Pre-treatment i.e. at diagnosis (on a biopsy of the tumour)
  2. Is this test carried out as a reflex test i.e. automatically or upon referral?
    • Reflex
  3. In their published adoption support resource NICE suggest identifying a named ‘clinical champion’ within each colorectal multidisciplinary team to effectively implement testing people for molecular features for Lynch syndrome. Is this established in your trust?
    • No
  4. Do you audit diagnostic outcomes within your trust to ensure that every patient is tested for molecular features for Lynch syndrome?
    • Yes, as part of private audit
  5. Have you had to submit a business case for funding in order to effectively implement this new guidance?
    • Yes, and additional funding was provided when required.
  6. If no such testing is in place, do you have information on whether there are any plans to introduce molecular testing for Lynch syndrome as per NICE guidance?
    • N/A
  7. What are the main barriers you have faced if no molecular testing or only selected testing is performed? Please specify.
    • N/A
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