Cancer Variant Interpretation Group UK (CanVIG-UK): an exemplar national subspecialty multidisciplinary network

Abstract

Advances in technology have led to a massive expansion in the capacity for genomic analysis, with a commensurate fall in costs. The clinical indications for genomic testing have evolved markedly; the volume of clinical sequencing has increased dramatically; and the range of clinical professionals involved in the process has broadened. There is general acceptance that our early dichotomous paradigms of variants being pathogenic-high risk and benign-no risk are overly simplistic. There is increasing recognition that the clinical interpretation of genomic data requires significant expertise in disease-gene-variant associations specific to each disease area. Inaccurate interpretation can lead to clinical mismanagement, inconsistent information within families and misdirection of resources. It is for this reason that 'national subspecialist multidisciplinary meetings' (MDMs) for genomic interpretation have been articulated as key for the new NHS Genomic Medicine Service, of which Cancer Variant Interpretation Group UK (CanVIG-UK) is an early exemplar. CanVIG-UK was established in 2017 and now has >100 UK members, including at least one clinical diagnostic scientist and one clinical cancer geneticist from each of the 25 regional molecular genetics laboratories of the UK and Ireland. Through CanVIG-UK, we have established national consensus around variant interpretation for cancer susceptibility genes via monthly national teleconferenced MDMs and collaborative data sharing using a secure online portal. We describe here the activities of CanVIG-UK, including exemplar outputs and feedback from the membership.

Keywords: clinical genetics; genetics; guidelines; molecular genetics; oncology.

Figure 1

Overview of the CanVIG-UK membership profile (survey of CanVIG-UK members, performed on 29 October 2019, return rate 83/103 (81%). HBOC, hereditary breast and ovarian cancer; MMR, mismatch repair. CanVIG-UK, Cancer Variant Interpretation Group UK.

Figure 2

Perceived utility of CanVIG-UK activities regarding local practice in CSG variant interpretation of seven activities (5: very useful to 1: not useful; survey of CanVIG-UK members, performed on 29 October 2019, return rate 83/103 (81%)). ACGS, Association of Clinical Genomic Science; ACMG, American College of Medical Geneticists; CanVIG-UK, Cancer Variant Interpretation Group UK; CSG, cancer susceptibility gene.