Abstract
Background
Molecular neuropathology is evolving rapidly, driven by novel genomic technologies, national policies, and the urgent need for precision brain tumour care. Inequity in access to genomic testing highlighted in previous reports warrants further investigation.
Methods
We analysed anonymised data from 21 United Kingdom (UK) neuro-oncology centres (covering an estimated 84% of the population) collected in 2021 and 2024 via the Tessa Jowell Centre of Excellence for Adults programme. We assessed trends in genomic testing (including methylation arrays, gene panels, whole genome sequencing (WGS)), tumour snap freezing, turnaround times (TATs), and auditing.
Results
From 2021 to 2024, total genomic tests submitted across the 21 centres increased 128% from 2946 to 6730, while glioma cases increased 18% (from 3159 to 3722). Methylation arrays, gene panels, and WGS samples submitted rose by 342%, 174%, and 291%, respectively. Centres requesting WGS increased from 4/21 (19%) to 15/21 (71%), with 90% centres (19/21) reporting snap freezing of brain tumour samples in 2024 (mean 173, range 0–650 samples frozen per centre). Mean molecular diagnosis TATs rose from 16 to 21 days; centres meeting a 14-day TAT dropped from 48% (10/21) to 30% (6/20). Auditing of TATs increased from 6/21 (29%) to 18/21 (86%).
Conclusions
UK molecular neuropathology testing grew substantially 2021–2024. However, variations in testing and snap freezing, and bottlenecks in diagnostic TATs, emphasise the need for: a) targeted training and investment in rapid technologies to ensure sustainable service delivery; b) focus on remaining inequities and c) continued engagement with national benchmarking initiatives.
Molecular neuropathology is evolving rapidly, driven by novel genomic technologies, national policies, and the urgent need for precision brain tumour care. Inequity in access to genomic testing highlighted in previous reports warrants further investigation.
Methods
We analysed anonymised data from 21 United Kingdom (UK) neuro-oncology centres (covering an estimated 84% of the population) collected in 2021 and 2024 via the Tessa Jowell Centre of Excellence for Adults programme. We assessed trends in genomic testing (including methylation arrays, gene panels, whole genome sequencing (WGS)), tumour snap freezing, turnaround times (TATs), and auditing.
Results
From 2021 to 2024, total genomic tests submitted across the 21 centres increased 128% from 2946 to 6730, while glioma cases increased 18% (from 3159 to 3722). Methylation arrays, gene panels, and WGS samples submitted rose by 342%, 174%, and 291%, respectively. Centres requesting WGS increased from 4/21 (19%) to 15/21 (71%), with 90% centres (19/21) reporting snap freezing of brain tumour samples in 2024 (mean 173, range 0–650 samples frozen per centre). Mean molecular diagnosis TATs rose from 16 to 21 days; centres meeting a 14-day TAT dropped from 48% (10/21) to 30% (6/20). Auditing of TATs increased from 6/21 (29%) to 18/21 (86%).
Conclusions
UK molecular neuropathology testing grew substantially 2021–2024. However, variations in testing and snap freezing, and bottlenecks in diagnostic TATs, emphasise the need for: a) targeted training and investment in rapid technologies to ensure sustainable service delivery; b) focus on remaining inequities and c) continued engagement with national benchmarking initiatives.
| Original language | English |
|---|---|
| Article number | npaf099 |
| Number of pages | 45 |
| Journal | Neuro-Oncology Practice |
| Early online date | 25 Sept 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 25 Sept 2025 |
Bibliographical note
Publisher Copyright:© The Author(s) 2025. Published by Oxford University Press on behalf of the Society for Neuro-Oncology.
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