Precision medicine in resource-limited settings: the central role of pathology

Abstract

Precision medicine (also known as individualized or personalized medicine) is a novel approach that integrates genetic, environmental, and lifestyle data to drive medical care decisions. It aims to give more precise approaches to illness prevention, diagnosis, and treatment.(1) In oncology, precision medicine is based on the premise that malignancies are not all the same, and people may respond differently to therapies depending on their genetic, environmental, and lifestyle variables.(2) In high-income countries, precision medicine is frequently associated with genomics and molecular profiling. The most common cancers (lung, breast, colorectal, prostate, stomach) all require histopathological diagnosis and immunohistochemistry (IHC) (e.g. ER/PR/HER2 in breast cancer) as part of the WHO Essential Diagnostics framework. Therefore, precision medicine does not have to include expensive whole-genome sequencing. Accurate pathology, basic immunohistochemistry, morphology, and low-cost molecular diagnostics can all provide precision treatment.