Multi-Gene Panel Testing: When One Test Isn't Enough

In India, where cancer rates are on the rise, understanding one's genetic risk is becoming more crucial. While a single genetic test may not be enough, multi-gene panel testing is changing how we approach hereditary cancer. By examining dozens of genes simultaneously, these tests provide a comprehensive view of a person's genetic makeup, enabling more precise and personalised healthcare decisions.

What is multi-gene panel testing?

Multi-gene panel testing is a single lab test that looks for mutations in multiple genes at once. A multi-gene panel might examine dozens of genes connected to several hereditary cancer types, whereas a single-gene test might only look for a mutation in one gene, such as BRCA1 for breast cancer. Next-generation sequencing technology makes this possible by enabling labs to sequence DNA faster and cheaper than ever before.

When to choose a panel test over a single test

A multi-gene panel is often advised when a person's family history of cancer is complex, meaning it involves several types of cancer across different relatives. It's also a good choice when a person's symptoms or cancer type could be linked to mutations in a variety of different genes. For example, if a patient has a personal history of both breast and ovarian cancer, a panel test can look for mutations in a range of genes that could be responsible for both. Relying only on a single-gene test in these cases could miss a key genetic link.

Pros, cons, and accuracy of panel testing

Panel testing benefits as follows -

• Comprehensive: Panels provide a more thorough risk assessment by detecting gene alterations that single-gene tests could overlook.
• Effective: Compared to conducting numerous single-gene tests one after the other, they are frequently more economical and time-efficient.

Things you should keep in mind while testing -

• Variants of Uncertain Significance (VUS): Genetic testing sometimes reveals unknown alterations called VUS. These results can feel unsettling because they don’t give patients or doctors clear guidance on the next steps.
• Unexpected results: Genetic tests may also show a risk for a type of cancer you weren’t initially concerned about. Facing such findings can be emotionally taxing.

These tests have a very high detection accuracy for known mutations. However, a VUS can be difficult to understand and necessitates thorough genetic counselling.

Cost and access considerations

The cost of multi-gene panel testing in India has been decreasing due to local labs and competition. While costs can vary, insurance coverage is becoming more prevalent, especially for patients with a strong family history of cancer. However, it's crucial to check with your insurance provider to understand what is covered. Many Indian diagnostic labs also offer financial assistance or payment plans. Consulting a certified genetic counselor is highly recommended to understand the costs and the implications of the test results.

Multi-gene panel testing represents a significant breakthrough in individualized cancer treatment by providing a more thorough and preventive strategy for those with a family history of the condition. This testing gives physicians and patients a greater understanding of genetic risk, enabling them to make decisions that will improve health outcomes