NHS 'ill-prepared' for genetic testing

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Genetic testing is set to revolutionise medicine but the NHS is ill-prepared to adopt it, a House of Lords committee has warned.

The capacity of science to tell people what diseases they are at risk from, and which drugs will help and which they will react badly to, based on their personal genetic make-up, promises better medical care in the future but will also impose heavy demands on doctors and increase costs.

Genetic tests are already widely available over the internet for around a $1,000 which promise to provide a DNA profile analysing your risk of serious conditions including heart disease, cancer and Alzheimer's disease.

But the Lords Science and Technology committee says that many consumers receive reports without medical advice to put them in context and most companies are based abroad beyond the reach of regulators so bogus claims cannot be policed.

Results of genetic tests are difficult to interpret because they deal in probabilities and do not mean the carrier will definitely develop the disease. They are based on scanning hundreds of thousands of common genetic variations, most of which have little impact on their own, but which in combination can significantly increase risk.

Doctors have become used to dealing with rare genetic diseases, such as Huntington's, where a single mutation determines the risk of developing the condition.

But when a woman with an increased risk of breast cancer, as revealed by her DNA profile, attends the surgery, the doctor faces a difficult decision whether to reassure her or advise her to start having regular mammograms sooner than usual.

The committee's report on genomic medicine, published today, says: "Genetic tests are placing increasing demands on doctors and nurses in mainstream specialties who are poorly equipped to use the tests effectively for diagnosis and treatment. Ensuring NHS staff have adequate training in genomic medicine will be vital."

In the course of its year long inquiry, the committee found "barriers" to the introduction of the new technology to the NHS, including concerns about privacy. It calls on the Government to produce a White Paper setting out the changes needed to bring genetic testing into mainstream medical practice.

Lord Patel, who chaired the inquiry, said: "Genomic medicine will clearly have a huge impact on health provision and the NHS in particular over the next few years. It is time for a comprehensive statement from the Government on how genomic medicine will be incorporated into the NHS."

Responding to the report, Professor Sir John Bell President of the Academy of Medical Sciences, said: "Genomics will have a major impact on healthcare, but a steady hand and a clear vision is required to use this research to deliver clinically useful and cost effective advances in healthcare."

"Innovative solutions will be required to overcome the obstacles of applying genetic testing more widely across the NHS. Current laboratory structures are already fragmented and there is a risk that introduction of new technologies will lead to further duplication."

The British Society of Human Genetics said more research was needed into the usefulness of genetic tests.

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