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Urgent action needed to reverse downward trend in pathology research

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Pathology research in the UK is at risk unless urgent action is taken to encourage more pathologists into research, a new report announced at the NCRI Cancer Conference in Birmingham reveals today (Sunday).

There are growing concerns that pathology research, essential for understanding disease, is under such pressure in the UK that developing new and more specialised treatments that tailor new drugs to patients will be badly affected.

To redress this downturn, the National Cancer Research Institute established the NCRI Pathology & Research Task Force to examine these issues and propose a series of actions to encourage and enable pathologists to engage with research.

They include proposals to rejuvenate and enable pathology research in medical schools, universities and the NHS; create a clear and practical pathway through the regulatory and governance framework to make pathology research more accessible and; a communication programme to promote and create enhanced recognition of the patient benefit arising from pathology research.

Up to 70 per cent of healthcare decisions taken in the NHS involve pathology based tests and investigations, and it is likely this will increase as more specialised medicines are developed. Herceptin is just one example of a personalised treatment that is now used in clinical practice to treat women with a type of breast cancer based on the pathology of their tumour. Developing more medicines of this type, where the new drugs are tailored to patients to achieve the best outcomes and avoid unnecessary side effects, is dependent on pathology expertise and support from pathologists to make tissue samples available for research.

The UK has seen a dramatic decline in its pathology workforce over recent years, resulting in a lack of capacity for pathology research. One of the reasons is that pathology is thought to have a low profile in undergraduate medical training and research and it is often not seen as an attractive career step for trainee doctors. There has been a decline in the number of academic pathology research posts.

Professor Peter Furness, president of the Royal College of Pathologists, said: “Pathology research is in urgent need of reinvigoration. We are on the verge of a major shift in how medical diagnosis is delivered and treatment is tailored to individuals, but the current state of pathology research in the UK means that we risk not being at the forefront. Actions now being taken by The Royal College of Pathologists and Medical Research Council will help to make pathology research a more attractive career option.”

The report found that many pathologists working in the NHS wish to participate in research but their contribution is limited by the availability of time after their day-to-day diagnostic work, and difficulties in achieving a fair reimbursement of costs.

Professor David Levison, chair of the NCRI Pathology & Research Task Force, said: “In response to concerns about the difficulties pathologists face in conducting research, we are pleased that the Comprehensive Local Research Networks, within the National Institute for Health Research in England, have committed around £2.7 million to help pathology departments support research during 2009/10.

“The UK has one of the best pathology resources in the UK – all tissue samples collected for routine diagnostics by the NHS are of great value to developing personalised medicines but more is needed to make them available for research. All patients should be given the opportunity to give consent for their samples to be used in this way.

“We are pleased that the Department of Health and the Scottish Government are both looking into this issue in more detail. The Human Tissue Authority and the National Research Ethics Service have also worked together to ensure a more streamlined process to make diagnostic samples available for research.”

In a survey to support the work of this Task Force, the biobanking advocacy organisation OnCore UK questioned over 200 pathologists and researchers for their views on the rules governing pathology research. This found that regulations were seen as too complex and that the available guidance can be confusing and unclear, deterring pathologists from research.

Dr Declan Mulkeen, Director of Research at the MRC, said: “Strengthening pathology research will increase the UK’s ability to develop stratified medicines – new drugs that are tailored to patients to achieve the best outcomes and avoid unnecessary side effects. The MRC is pleased to be contributing to rebuilding the pathology research workforce and helping pathologists navigate a clear path through the regulatory environment.”

Professor David Levison added: “We are pleased that a number of different organisations and bodies have agreed to work together to redevelop pathology in this country. We will closely monitor this work and we hope this will lead to improvements in pathology research in the UK over the coming years.”