Could molecular pathology testing in lung cancer be more cost effective?

Kathy Walsh, Yuan Kheng, Anca Oniscu, David James Harrison, William Wallace

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Aims: EGFR and ALK analysis is routinely undertaken prior to targeted treatment of non-squamous non-small cell lung carcinoma (NSCLC). Increasingly limited resources require molecular pathology services to be cost effective without detriment to patient care.
Methods: Data from an audit of molecular pathology testing in the South East of Scotland Cancer network has been used to explore different testing strategies with the aim of reducing costs; including investigation of TTF1 expression as a negative predictor for EGFR mutations.
Results: TTF1 immunohistochemistry had a high negative predictive value for EGFR mutations (99%). Reflex testing all non-squamous NSCLC had the highest costs whereas limiting testing to those who might be considered for treatment would save 7.5%; the serial model could save 32.7%.
Conclusions: Testing only patients being considered for EGFR and ALK inhibitors represented small savings; more significant savings would be achievable if testing algorithms utilized known associations between clinical biomarkers.
Original languageEnglish
Pages (from-to)938-941
JournalJournal of Clinical Pathology
Issue number10
Early online date7 Jul 2016
Publication statusPublished - Oct 2016


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