Genomics and Molecular Surgery
Genomics and molecular surgery are transforming the landscape of healthcare and surgical practice. In 2003, sequencing the human genome took 13 years and cost over $3 billion. Today, it can be completed in under 24 hours for less than £1,000. These remarkable advances are enabling more personalised treatments and improving patient outcomes across a range of conditions.
Techniques such as next-generation sequencing, circulating tumour DNA analysis, polygenic risk scoring, pharmacogenomics, and personalised therapies, including cancer vaccines are already influencing surgical decision-making and care pathways.
Our vision
As part of the Future of Surgery programme, we have established a dedicated team to lead our work in genomics and molecular surgery, chaired by Mr Frank Dermott. We are developing an ambitious genomics programme, shaped by insights from surgeons, healthcare professionals, patients and the public.
Our aim is to address unmet needs in this evolving field, ensuring surgical practice reflects the latest scientific developments. We are committed to working collaboratively across the sector to enhance patient care and support surgeons with the education and training they need.
Educational resources
To explore the fundamentals of genomics in surgery, we recommend the free resources available through the Genomics Education Programme, GeNotes.
Why does genomics matter in surgical practice?
Genomics is already influencing surgical care in meaningful ways. Below are some key areas of application:
- circulating tumour DNA (ctDNA): a blood test that detects tumour DNA, used in screening, diagnosis, post-operative surveillance, and identifying minimal residual disease. NHS England has commissioned ctDNA testing for lung and breast cancer.
- next-generation sequencing (NGS): enables rapid, cost-effective analysis of multiple genes or the entire genome. It comprises tests that assess multiple genes (gene panel), the whole exome (all of the coding regions), the whole genome (coding and non-coding) and other tests such as RNA sequencing.
- cancer vaccines: a form of immunotherapy that primes the immune system to target cancer cells. Different types of cancer vaccines are available, and studies are underway to assess their efficacy in lung, colorectal, and skin cancer.
- pharmacogenomics: examines how an individual’s genetic makeup affects their response to drugs. Examples include:
- polygenic risk scores: combine multiple genetic variants to estimate an individual’s risk of developing certain conditions.
- diagnosis of rare inherited conditions and cascade testing: advances in sequencing have made it easier and cheaper to confirm genetic diagnoses and offer testing to at-risk relatives. This enables early intervention or discharge from surveillance, and includes options such as preimplantation genetic diagnosis to allow people with some inherited conditions to have children without passing on a genetic abnormality.
Get involved
Genomics and molecular surgery are reshaping how we understand disease, improve surgical outcomes and personalise care. We invite the surgical community to engage with this work and help shape the future of surgical genomics.
Future of Surgery Festival, 20–21 April 2026, ICC Birmingham.
We’re bringing together surgeons and surgical teams for a first-of-its-kind UK festival dedicated to the future of surgery. With over 25 hours of curated content, workshops and the latest technology demonstrations, it’s more than an event; it’s a celebration of surgery. Bookings open this autumn.Register now for early access and tickets
Additional resources
Papers
- Current and future genomic applications for surgeons. (The Annals of The Royal College of Surgeons of England)
- The impact of cancer genomics across the surgical pathway. (Surgery)