The National Public Health Laboratory of Nepal has validated next-generation sequencing for breast cancer, with many oncologists no longer needing to send specimens of suspected cancer patients to India for testing.

With the development, patients or their relatives will also pay about half the cost they were paying in India.

"We have successfully validated next-generation sequencing for breast cancer," said Ranjan Raj Bhatta, director at the laboratory.

"Now doctors do not need to send samples to India. We will provide the service at almost half the price patients have been paying in India."

Next-generation sequencing is a technology for determining the sequence of DNA or RNA to study genetic variations. This technique can detect rare causative variants for monogenic conditions when many possible mutations exist.

Due to a lack of such a service within the country, hospitals treating cancer patients had to send samples to India and it would take several weeks for the test results to arrive.

Patients who are suspected to be suffering from cancer, as well as their families, had to anxiously wait for confirmation of the diagnosis.

"We will provide the result within three weeks," Bhatta said. "It currently takes around four weeks for reports to come from India. We can provide reports earlier, but it depends on the number of samples from suspected cancer patients. Carrying out testing on fewer samples costs more, so we sometimes need to wait longer."

Doctors say that the start of the service by the laboratory helps patients and their families get reports more quickly, which in turn will help doctors to start treatment earlier. Starting treatment on time makes a big difference in recovery from cancer, according to them. It is estimated that only about 2,000 Nepalis undergo breast cancer screening every year.

Medical gap

The latest report released by the International Agency for Research on Cancer suggests that breast cancer is the most commonly diagnosed cancer among women and the leading cause of incidence in 157 countries and mortality in 112 countries.

Breast cancer mortality rates vary significantly across regions in both geographic and temporal terms, which appears to correlate with the extent of basic healthcare coverage.

Compared to developed countries, most developing nations, including Nepal, have a lower incidence of breast cancer but a higher mortality rate for weaker healthcare infrastructure and delayed diagnoses.

The World Health Organization launched the Global Breast Cancer Initiative in 2021 to reduce mortality rates by 2.5 percent a year by 2040 to save 2.5 million lives through three key pillars of action on health promotion for early detection, timely diagnosis, and comprehensive breast cancer management.

Meanwhile, the public health laboratory said that along with next-generation sequencing for breast cancer, preparations are underway to begin genomic testing for four other cancers, including leukemia.

Experts say the start of next-generation sequencing and genomic testing also helps maintain databases and ensure genomic confidentiality and privacy, which are essential for research and making policies on disease management.

Oncologists say not all cancer treatment centers require all types of diagnostic services, as testing is costly and some centers do not get enough samples.

They also said that hospitals can be encouraged to start super-speciality services through tax concessions.

The Kathmandu Post, Nepal