ONCOLOGY
Detection to direction: the future of precision oncology diagnostics
Advances in molecular and genomic technologies are transforming oncology diagnostics, bridging screening, risk stratification, and treatment selection into a connected model of early cancer detection.
As a leading cause of death worldwide, cancer remains one of the most pressing challenges in modern healthcare.1 Improving survival outcomes depends on timely and accurate testing, access to high-quality treatment, and effective long- term follow-up care.
Among advances in cancer
management over the past two decades, one of the most profound revolutions has occurred in diagnostics. While a cancer diagnosis can be life-changing for any individual, it also marks the beginning of a structured clinical journey. Once limited to identifying malignancy and confirming disease, oncology diagnostics now extends far beyond detection. It informs
clinical decisions throughout the cancer pathway, from identifying individuals at risk, to guiding targeted therapy and monitoring treatment response. This evolution marks a fundamental shift in healthcare, from reactive disease management to proactive prevention and personalised care. Reflecting this, the NHS 10 Year Plan emphasised earlier diagnosis, faster diagnostic pathways, and equitable access to innovation.2 At the heart of this transformation lies the diagnostic laboratory, now integrating molecular, genomic, and digital technologies to uncover the biological drivers of disease and predict therapeutic response. As tumour biomarkers,
genomic signatures, and digital tools continue to advance, diagnostics are redefining modern oncology, shifting the focus from detection to direction.
Diagnostics and screening For patients and clinicians, diagnostics guide nearly every important decision, before during and after therapy to support their best possible recovery and long-term health (Fig 1). Cancer screening represents the first step in the diagnostic continuum, identifying individuals who may have cancer or are at higher risk before symptoms arise. Earlier diagnosis remains one of the strongest determinants of cancer survival; however, many cancers are still not detected early enough to impact outcomes. This is often due to limited screening availability or the lack of specificity in existing screening tools.1 For example, the prostate-specific antigen (PSA) test, though widely used, has limited specificity and can generate false positives, leading to unnecessary MRI scans and biopsies that cause anxiety, increase costs, and place pressure
Fig 1. The evolving role of oncology diagnostics across the cancer care pathway.
WWW.PATHOLOGYINPRACTICE.COM DECEMBER 2025 27
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