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Genomics has the power to transform cancer care, but only if it is implemented equitably and inclusively.
Australia has the world’s best cancer outcomes, but certain populations — including Aboriginal and Torres Strait Islander people, those living in rural and remote areas, culturally and linguistically diverse groups, and people with rare cancers — do not share this experience and have limited access to cutting-edge technologies. Addressing these disparities requires a multifaceted approach.
Recognising the critical importance of genomics in cancer care, the Australian Government launched the National Framework for Genomics in Cancer Control in February 2025 as a key action of the Australian Cancer Plan. The vision of this framework is clear: to integrate cancer genomics into routine clinical practice as the standard of care while ensuring accessibility, cultural safety and equity across the cancer care continuum. Together with the upcoming launch of Genomics Australia, we have a significant opportunity to align efforts and accelerate the integration of genomics in cancer care.
Last month, the Australian Government announced the establishment of a $3 million Cancer Genomics Clinical Trials Fund to drive advancements in genomic medicine and ensure equitable access to cancer clinical trials incorporating genomics. This new fund is a significant first step in implementing the framework and addressing key objectives for genomics-informed diagnosis, treatment, clinical trials, research and data.
The role of genomics in cancer care
Cancer is fundamentally a disease of the genome, involving mutations in DNA that can lead to uncontrolled cell growth. With advances in technology, we can identify genetic predispositions to cancer, enabling early intervention and personalised risk-reduction strategies. Genomic testing can also help determine the most effective, least toxic treatment plans, improving patient outcomes and quality of life.
The need for genomic literacy in cancer care
While the rapid advancement of genomics offers exciting possibilities, it also presents challenges, including the need for improved genomics literacy among both health care professionals and the broader public.
The volume of available information on genomics is expanding rapidly. It is crucial that patients can access accurate, reliable and evidence-based information and that medical professionals remain a trusted source for genomics guidance. This includes an understanding of the germline and somatic testing, the role of cascade testing, and the types of genomic testing, including whole genome sequencing, panel testing and tumour mutational burden.
To support clinicians in navigating these complexities, resources such as the eviQ referral guidelines for cancer genetics assessment are essential. By equipping health professionals with practical tools, we can improve personalised prevention, risk-reducing strategies, early detection and personalised treatment plans, ultimately leading to better patient outcomes.
Addressing equity: ensuring genomics benefits all Australians
Equity in cancer care is a fundamental measure of success under the framework. Without intentional efforts to improve access, there is a risk that genomic advancements will exacerbate existing health care inequities.
Ensuring culturally safe genomics-guided cancer care is a priority. This requires ongoing consultation and collaboration with Aboriginal and Torres Strait Islander communities who have higher cancer mortality rates and face barriers in accessing genomics-informed care.
In 2024, Cancer Australia conducted in-person workshops with Aboriginal and Torres Strait Islander community members, cancer patients, health care providers and community-controlled health services. These consultations reinforced the importance of self-determination, culture, capacity building, and access in shaping the future of cancer genomics care.
Moving forward: what needs to happen next?
The launch of the framework is just the beginning. Successful implementation requires a coordinated effort from the entire health care sector, including governments, researchers, health care providers, and advocacy groups.
Cancer Australia has identified four key priorities for implementation:
- Integration into routine clinical practice
- Establishing genomics as a standard component of cancer care to enable personalised cancer prevention and early detection and to guide treatment decisions.
- Ensuring evidence-based genomic testing is available and accessible to patients regardless of geographic location or socio-economic status.
- Promoting translational research and enabling timely access to genomics-informed cancer treatments through Health Technology Assessment processes and clinical trials.
- Public awareness and workforce education and training
- Enhancing genomics literacy among all health care professionals to ensure clinicians are confident in using genomics to guide cancer prevention and treatment.
- Developing community awareness campaigns about cancer genomics and co-designing resources with priority populations and consumers.
- Driving system level changes relating to cultural safety, with education for health providers that acknowledges the complex history of genomics for Aboriginal and Torres Strait Islander people.
- Data and research
- Strengthening data-sharing capabilities to maximise the benefits of genomics research and improve real-world applications.
- Ensuring cancer genomic research and data are representative of population diversity, underpinned by Indigenous data sovereignty principles.
- Equity and cultural safety
- Developing tools for the specialist cancer workforce and primary care, including Aboriginal Community Controlled Health Services, to support shared decision making with patients about the use of genomics in cancer care.
- Providing Aboriginal and Torres Strait Islander people and other priority populations with holistic navigation support and wrap-around personalised genomic cancer care.
Conclusion
Genomics has the power to transform cancer care, but only if it is implemented equitably and inclusively. The National Framework for Genomics in Cancer Control provides a roadmap for ensuring all Australians, regardless of background or location, can benefit from the latest advancements in personalised cancer care. However, achieving this vision requires commitment from the entire health care sector. Cancer Australia is committed to leading this charge, ensuring that genomics serves as a tool for better outcomes, improved patient experiences, and a more equitable cancer care for all Australians.
Professor Dorothy Keefe is the CEO of Cancer Australia
Adjunct Professor Jacinta Elston is Cancer Australia’s Advisor on Aboriginal and Torres Strait Islander Cancer Control
The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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