# Every tumour genomic report machine-readable and deposited nationally

Source: https://onco.cc/ideas/idea-data-structured-genomic-reports/  
OnCo record `idea-data-structured-genomic-reports` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Genetic test results for tumours are mostly PDFs. Require labs to also send a computer-readable version to a national store, so variants can be linked to what treatments worked.

## Summary

NGS reports from commercial and hospital labs are delivered as PDFs; the structured variant calls rarely enter the record. The HL7 Genomics Reporting implementation guide and mCODE genomics profiles define the format. The proposal requires, as a condition of payer coverage for tumour sequencing, that laboratories deposit structured variant, TMB, MSI and fusion data to a national variant-outcome store linked to registry outcomes, building on AACR Project GENIE and Genomics England.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: A payer-mandated structured deposit will link genomics to outcomes for more than 80 percent of sequenced patients within three years, allowing variant-level outcome queries (for example rare KRAS alleles) that currently require bespoke consortia.
- Rationale: GENIE showed that pooled genomic-clinical data across 19 centres yields answers on rare variants no single centre can; a mandate extends this from volunteer academic centres to all sequenced patients.
- Proposed test: Pilot with one national payer and the three largest commercial labs: measure the proportion of covered tests deposited in structured form and time to first published variant-outcome analysis.
- Maturity: early-clinical
- Actor: payer

## Sources

- HL7 Genomics Reporting IG: https://hl7.org/fhir/uv/genomics-reporting/
- AACR Project GENIE: https://www.aacr.org/professionals/research/aacr-project-genie/

## Connected records

- collections: [AACR Project GENIE](https://onco.cc/collections/genie/), [cBioPortal for Cancer Genomics](https://onco.cc/collections/cbioportal/), [CIViC](https://onco.cc/collections/civic/), [OncoKB](https://onco.cc/collections/oncokb/)
- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/)
- terms: [Next-generation sequencing (NGS)](https://onco.cc/terms/ngs/)
- technologies: [Comprehensive genomic profiling](https://onco.cc/technologies/cgp/)
- companies: [Caris Life Sciences](https://onco.cc/companies/caris/), [Foundation Medicine (Roche)](https://onco.cc/companies/foundation-medicine/), [Guardant Health](https://onco.cc/companies/guardant-health/), [Tempus AI](https://onco.cc/companies/tempus/)
- bottlenecks: [Data silos](https://onco.cc/bottlenecks/b-data-silos/), [Rare and paediatric cancers without markets](https://onco.cc/bottlenecks/b-rare-cancers/), [Weak real-world evidence and registries](https://onco.cc/bottlenecks/b-real-world-evidence/)
- ideas: [Link every national cancer registry to tumour genomics](https://onco.cc/ideas/idea-data-registry-genomics-linkage-programme/)

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