TORONTO - Genetic discoveries that allow doctors to better diagnose and target cancer treatments are rapidly evolving, but the health-care system is not keeping pace by providing tests that fully capitalize on these advances, a report by a Cancer Care Ontario task force says.
The Molecular Oncology Task Force released recommendations Monday aimed at ensuring that Ontarians have access to a broad range of genetics-related testing and that the health-care system can meet that demand.
Ontario labs routinely use dozens of genetics-based tests, including those to determine if women carry the BRCA1 or BRCA2 mutation that predisposes them to an aggressive type of breast cancer and ovarian cancer.
The ability to zero in on what genetic mutations have led to a specific cancer can help doctors administer more targeted drug treatment for an individual, while avoiding other forms of chemotherapy that are doomed to fail but carry toxic side-effects.
"The advances in this field allow us to test a person for predisposition to cancer and for treatment to be tailored to the patient's cancer," said Terry Sullivan, CEO of Cancer Care Ontario. "It is imperative that our health system keep pace with these developments by making these tests available in a safe and sustainable manner."
But task force chair Dr. Suzanne Kamel-Reid said the introduction and use of new tests aren't keeping up with advances in science.
Between 2000 and 2007, more than 2,000 disease genes were discovered by scientists worldwide. In North America, more than 1,500 molecular tests are being used for patients, but less than 300 are available in Ontario.
"When you compare the number of tests offered in our province compared to other jurisdictions, we are actually falling quite far behind," Kamel-Reid said.
Among the task force recommendations to the Ontario government:
-Establish a body to oversee system planning for molecular oncology services.
-Implement a mandatory approval process for each genetic test, ensuring that only accredited and licensed laboratories report and interpret results.
-Ensure each genetic test meets rigorous quality-assurance criteria.
-Develop a sustainable system for evaluating and funding new cancer tests so patients have access to tests and targeted treatments based on the results.
Sullivan said the task force recommendations need to be acted on immediately, starting with the oversight body for expanding testing services.
"This door to discovery with molecular oncology testing is opening now and it's opening wide," Sullivan said. "And the pace of discovery of new genes is likely to eclipse cancer incidence as a driver of service demand over the next couple of decades."
