Request 1

Bowel Cancer UK is requesting the following information relating to the commissioning of NICE guidance DG27: Molecular testing strategies for Lynch syndrome in people with colorectal cancer, within your geographical area.

Do you commission first line screening e.g. full 4 antibody IHC and/or MSI for molecular features of Lynch syndrome in all newly diagnosed bowel cancer patients?

Response 1

No, we do not commission this test – this is not routinely commissioned and would require a request through the Individual Funding Request Panel for exceptional approval.

Request 2

If first line screening is currently commissioned (either in all cases or as a subset) are second and third line genomic tests being commissioned in cases of MLH1 loss i.e. BRAF mutation and MLH1 promoter methylation, as per DG27 NICE guidance?

Response 2

N/A – please see response 1

Request 3

If the full NICE guidance (DG27) is not currently implemented, do you intend to commission screening for molecular features of Lynch syndrome in all newly diagnosed bowel cancer patients across your area?

Response 3

No, we do not intend to commission DG27 – as per the response to Q1.