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The most common challenges we face are shortages of laboratories and personnel, lack of awareness and education among patients, healthcare providers, and policymakers, and reluctance to prioritize and invest in cancer biomarker testing. 

Laboratories and Equipment (Infrastructure) 

Many countries do not have enough laboratories qualified to perform biomarker testing. In locations where biomarker testing must be done in a laboratory far away, even having the right equipment and reliable electricity to keep samples at the correct temperature can be challenging. In regions where a qualified laboratory facility is available, the cost of equipment, as well the cost and effort of laboratory and equipment maintenance, is still an obstacle to access. 

Medical and Laboratory Personnel (Health Manpower)  

Some regions do not have enough pathologists to manage biomarker testing for all. We need people passionate about change within medical education to increase awareness of the pathology specialty and encourage medical students to choose it. In addition to a shortage of pathologists, there are not enough trained laboratory personnel. More laboratory staff is needed to decrease biomarker testing turnaround times and increase laboratories’ capacity to conduct quality assurance programs.  

Awareness and Education  

Awareness and understanding of biomarker testing among patients are increasing, but there is still a lot of work to be done. In a survey conducted among colorectal cancer patients and survivors by GCCA, fewer than half of the people who responded said that they were sure they had biomarker testing, had discussed their results with their healthcare team, and that they understood how their biomarker testing results could impact their treatment options. We are working with advocates and partners to change this. The Know Your Biomarker program is building awareness through collaboration with patient spokespeople who share their biomarker testing stories and encourage others. And we are building understanding through educational materials written specifically for patients. 

As research advances the use of biomarker testing and targeted therapies in colorectal cancer, healthcare providers, including those in surgery, pathology, and oncology, need continuing education to order the right biomarker tests, to properly collect and prepare tumor samples for specific biomarker testing, to interpret results, and to translate them into a plan of action for patient care. 

Priorities and Investment 

More than half of cancer drugs launched in the last five years are targeted therapies for which biomarker testing is recommended or required. It must be a priority of regulators and governments to encourage, approve, and cover cancer biomarker testing to ensure patients are getting the treatment they need and deserve. In some countries, this includes policies requiring health insurers to cover biomarker testing as well. 

Regulators and governments must invest in patient-centered policies. Reimbursement policies are the guidelines set by regulators, governments, and insurers that determine which biomarker tests are paid for, how much is paid for those tests, and how much must be paid out-of-pocket by patients. Currently, these policies are not keeping pace with the medical research and clinical practice guidelines on biomarkers and targeted therapies. Medically appropriate biomarker testing and targeted therapies need to be covered to ensure patients are getting the care they need.  

To increase access and reduce health disparities, we need to address these barriers. And to be successful and see change, it takes individuals, organizations, and partnerships with policymakers.