Research in pathology has increasingly come to involve molecular techniques, so that these are currently routine in academic histopathology and genetics laboratories. Molecular markers—largely from tumours, but also from the germline—have great potential for diagnosis, for directing treatment, and as indicators of outcome. However, in general, clinical practice has lagged behind research in molecular histopathology. This is in contrast to clinical genetics, in which cloning of disease genes has usually led to the introduction of molecular testing soon afterwards.

The question remains unanswered as to why histopathology departments have been slower to instigate molecular testing; but there are several clues. Is medical science at fault for not providing useful molecular markers? Are there problems bringing together the expertise from National Health Service (NHS) laboratories of molecular genetics, cytogenetics, and histopathology? Is there not only an inevitable lack of funding, but also an absence of sympathy for molecular techniques? Is there a lack of coordination between different groups, and could the Royal College of Pathologists act as a force to drive forward molecular pathology in the NHS?

To examine these …