Mainstreaming of genomics in oncology: a nationwide survey of the genomics training needs of UK oncologists

Abstract

Objective: Genomics is rapidly changing treatment paradigms for cancers, obligating oncologists to have good genomics knowledge. Through this survey, we aimed to assess the current understanding of cancer genomics among UK oncologists.

Methods: We conducted a web-based nation-wide self-assessment survey of the cancer genomics knowledge of UK clinical and medical oncology trainees and consultants.

Results: In total, 150 oncologists (81 consultants and 69 trainees) responded, representing 10% of UK oncologists.Formal training in genomics had not been received by 38.7% of oncologists and 92.7% identified a need for additional genomics training.In total, 71.3% self-reported to have good knowledge of defining somatic and germline mutations, falling to 35.3% for understanding principles of gene expression and regulation. Knowledge of cancer-predisposing syndromes was highest for Lynch syndrome (40.7% good knowledge) and lowest for multiple endocrine neoplasia (14.0% good knowledge).Overall, 49.0% of respondents had consented patients for germline testing, but 80.7% reported a lack of training in genetic counselling.

Conclusion: Large knowledge gaps have been identified through this survey, highlighting the need for incorporation of improved formal training in cancer genomics for consultants and trainees, with an aim to equip oncologists for advances in clinical practice and to take up genetic mainstreaming confidently.

Keywords: genomics; germline genetics; mainstreaming; oncology; somatic genetics.

Fig 1

Previous training received in cancer genomics and the different formats of teaching. (a) Has specific training in cancer genomics been completed? (b) Format of teaching. ICR = Institute for Cancer Research.

Fig 2

Respondents' perception of basics of genomics. Total respondents: 150. A = all; B = consultants; C = trainees.

Fig 3

Describing the pattern of malignancies and underlying gene mutations associated with various high-risk cancer predisposition syndromes. A = all; B = consultants; C = trainees.

Fig 4

Respondents' knowledge of local clinical genetics services. A = all; B = consultants; C = trainees.

Fig 5

Respondents' knowledge of interpreting and communicating results. A = all; B = consultants; C = trainees.

Fig 6

Reported need for specific training in cancer genomics. (a) Do oncologists feel the need for further training? (b) Preferred format for delivery of training.