The National Genomic Test Directory for Cancer  specifies the genomic tests commissioned by NHS England for cancer, eligibility criteria, and how to order them.

The tests we provide may inform diagnosis and prognosis across a diverse range of cancer types, as well as revealing gene variants which provide treatment opportunities via targeted therapies.

Most tests in the Cancer Test Directory are provided by one of the regional laboratories that are part of the Central and South Genomic Laboratory Hub (C&S GLH). Initial test requests will be triaged by the nearest laboratory to clinicians, who will ensure the sample is sent to the relevant lab. A small number of specialised tests are not provided by the C&S GLH. These tests will be sent to other laboratories across England, as part of the wider Genomic Medicine Service network. This will not affect the ordering or referral process.

Whole Genome Sequencing (WGS) is commissioned by NHS England for a sub-group of patients with solid cancers. More information and test information sheets can be accessed by clicking here.

Further information about cancer tests provided within your local Genomic Laboratory Hub lab can be found on the relevant websites below.

8 April 2026

The first version of the National Genomic Test Directory for Cancer was not particularly easy to use:

  • Single tests (e.g. 1p19q codeletion FISH) were represented multiple times in the NGTD, each for a different tumour type
  • It required that you know what the tumour type is when requesting a test, when often the purpose of the test was to establish the tumour type

The NGTD has therefore been simplified and aligned with clinical practice. Rather than selecting individual test codes for a particular tumour type, you now request a single ‘Test Package’. Each Test Package is based around a particular diagnostic issue, and includes multiple tests to address that diagnostic issue.

Rather than having to select many individual tests, you now need to request only one or a few test packages.

The NGTD lists each Test Package, with all the legacy tests which each package includes. The updated version of the National Genomics Test Directory can be found by clicking here.