ideasIdea
Mandatory national virtual tumour boards for rare and complex cancers
A patient with a rare cancer treated at a small hospital should have their case reviewed by the national experts by video before treatment starts. Make that referral automatic.
Outcomes for sarcoma, rare gynaecological tumours, and other uncommon cancers depend heavily on expert review before surgery, yet many patients are treated locally without it. National virtual multidisciplinary boards, with mandatory pre-treatment referral for a defined list of diagnoses and a turnaround guarantee, have been implemented for sarcoma in several countries. Extending the model with a legal or reimbursement mandate would standardise access.
Hypothesis
Mandatory national virtual review for listed rare cancers will increase the proportion treated according to expert recommendation from under 50% to above 85% and improve margin-negative resection rates.
Rationale
Centralised expertise with decentralised delivery is the accepted model for rare disease; the internet removes the geographic excuse.
What would test it
Implement nationwide with a registry comparison of concordance, resection quality, and survival before and after the mandate.
Maturity
being tested at scale
Who has to act
policy
Cost to try
Small (under $1M)
Years to first evidence
2
Bottlenecks it attacks
- Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.
- Rare and paediatric cancers without markets · Taken together rare cancers are a fifth of all cancers, but each one alone is too small for a company to invest in.