4 Tips for adopting molecular testing strategies
4 Tips for adopting molecular testing strategies
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Ensure the colorectal team, and local histopathology and specialist clinical laboratory staff have the appropriate level of awareness training and education. This is needed to ensure that staff:
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Request the correct tests for all people who should be tested (either automatically, or according to a protocol).
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Are able to correctly carry out and interpret the results of the genetic tests.
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Prepare tumour samples appropriately; see developing local documentation for examples of a letter to a histopathology lab requesting tumour samples for MLH1 hypermethylation testing and a form describing the material needed for immunohistochemistry testing.
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Refer patients to clinical genetics services correctly; see developing local documentation for an example letter to support referral to clinical genetics.
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Are able to provide support and information for people regardless of the testing outcome.
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Communication between colorectal teams, clinical genetics services and patients is important. Attendance at colorectal multidisciplinary team (MDT) meetings is 1 method to support this as is the development of resources such as referral guides, flow charts and patient information sheets (see developing local documentation).
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Ensure laboratory protocols are in place which lead to automatic mismatch repair (MMR) testing and inclusion of results within standard histopathology reports. This protocol should also cover further sequential testing when indicated. Development of such a protocol should involve representatives from the colorectal team, histopathology laboratory, specialist clinical laboratory and clinical genetics to ensure systems are in place for transporting and tracking samples or results and that it is clear who is accountable and responsible for following up results.
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