Thousands of cancer patients from minority ethnic communities are set to benefit from innovative genetic testing provided by the NHS, which previously failed to adequately address their needs.
This essential genetic testing, which is conducted prior to chemotherapy treatments, has the potential to significantly improve survival rates for Black and minority ethnic cancer patients who typically experience worse health outcomes after a cancer diagnosis compared to their white peers.
In England, cancer patients routinely undergo genetic testing before starting chemotherapy to help minimize the risk of adverse reactions to the treatment. These reactions can range from mouth sores and hair loss to nausea, fatigue, and in severe cases, death. Research indicates that up to 40% of the 38,000 patients receiving fluoropyrimidine-based chemotherapy in England may suffer from adverse drug reactions.
Historically, these genetic tests focused on only four types of DPYD gene variants, which predominantly occur in individuals of white European descent. As a result, Black cancer patients were at a disadvantage, facing a higher likelihood of severe side effects, including fatal outcomes, after chemotherapy.
The NHS has now expanded its genetic testing across England to include a fifth DPYD genomic variant that is more prevalent among Black and minority ethnic individuals. Prior to this addition, Black cancer patients could mistakenly be deemed safe for chemotherapy dosages, as the tests were not designed to detect their specific variant.
Professor Veline L’Esperance, a senior clinical adviser at the NHS Race and Health Observatory, remarked that the introduction of these revised genetic tests marks a significant advancement for patients historically overlooked by the healthcare system.
“Patients of African descent deserve the same safety standards as everyone else, and now healthcare providers are equipped to ensure this,” L’Esperance stated. “This is a pivotal moment that shifts the dialogue surrounding ethnic health disparities in cancer care from mere discussion to actionable solutions. It is the first substantial clinical response to the evidence that Black and ethnic minority patients have been inadequately served by tests based on white European genetic profiles.”
“Historically, cancer drug safety research has centered around white populations, leading to a lack of understanding of variants that are more frequently found in Black, African, and other minority ethnic groups. This gap means that safety measures have not been universally effective.”
Since the implementation of this testing at Manchester University NHS Foundation Trust last September, three cancer patients from minority ethnic backgrounds have benefited from the new genetic assessments, which allowed for personalized chemotherapy dosages that mitigated the risk of severe reactions to treatment.
Black and Asian cancer patients often encounter significant disparities in health outcomes and care. Prior studies have shown that individuals from ethnic minority backgrounds typically experience longer waits for cancer diagnoses than white patients, require more consultations with general practitioners before receiving a diagnosis, and often feel inadequately supported during hospital treatment for cancer.
Professor Habib Naqvi, the chief executive of the NHS Race and Health Observatory, emphasized that the new genetic testing represents a revolutionary development in chemotherapy administration, already yielding positive outcomes for patients.
“Genomics and precision medicine are at the forefront of medical advancement, promising targeted and effective treatments. However, it is critical to note that ethnic minority groups remain underrepresented in medical research and genomic databases. Research must engage diverse populations to ensure that medical breakthroughs benefit everyone,” Naqvi stated.
Professor Dame Sue Hill, chief scientific officer for NHS England and senior responsible officer for NHS Genomics, expressed her enthusiasm regarding the discovery of the fifth gene variant, which allows for personalized chemotherapy, enhancing care quality and reducing harmful side effects, potentially saving lives.
“The North West NHS Genomic Medicine Service has already demonstrated how this approach can improve treatment for patients of African descent, reinforcing the NHS’s commitment to addressing racial and health disparities in cancer care, ensuring equitable access and opportunities for all patients,” Hill added.
