In this episode of The Road to Tripartite 2025, Sara Gortázar, colorectal surgeon and ESCP Committee member, speaks with two exceptional early-career professionals from the Young European Hereditary Tumour Group (Y-EHTG) Committee, Alethea Tang and Neil Ryan.
In the interview below, together they explore the intersection of genetics, multidisciplinary collaboration, and how the next generation of clinicians is advancing hereditary cancer care across specialties.
Sara Gortazar (SG): Can you briefly introduce yourself and your current role within the European Hereditary Tumour Group?
Alethea Tang (AT): I am a Specialty Registrar and Honorary Clinical Lecturer in General Surgery, with a subspeciality interest in colorectal surgery. I am currently training in Wales, United Kingdom and am part of the Y-EHTG committee.
Neil Ryan (NR): My name is Dr Neil Ryan. I am the Director of Education for the European Hereditary Tumour Group (EHTG) and previously served on the Y-EHTG board. In my current role, I lead the group’s educational initiatives and also run the EHTG podcast series, which highlights cutting-edge research and clinical developments in hereditary cancer. Clinically, I am a subspecialty trainee (SST) in gynaecological oncology and a clinical lecturer at the University of Edinburgh. My research focuses on hereditary gynaecological cancers, particularly mechanisms of tumour development and opportunities for early detection. Through my roles in EHTG, I am committed to building international collaboration and delivering high-impact educational resources that support both clinicians and researchers in the field.
SG: What motivated you to become involved with the EHTG, and particularly in representing its younger members?
AT: I was first introduced to EHTG when I was pursuing my PhD studies. Part of my project looked into the feasibility of using Raman spectroscopy in the context of colorectal surveillance for Lynch syndrome and thought that attending the EHTG conference would give me a greater understanding of the research landscape pertaining to hereditary colorectal cancers. I met some members of Y-EHTG at our last face-to-face meeting in Lithuania (2023) and the rest I would say is history.
Hereditary colorectal cancer can be a fairly niche subject with a lot of research mainly focused on sporadic colorectal cancers. It was useful to meet other people who were doing research in the same field. This is often multidisciplinary, which adds to the richness of understanding of a particular subject area. Being a clinician and early career researcher can be a challenging time. Having had help with navigating some aspects of my research career, I wanted to ensure younger members were similarly supported as they navigate through their own careers.
NR: I became involved with the EHTG early in my academic training, drawn by its unique focus on hereditary cancer and its collaborative, cross-disciplinary approach. As a gynaecological oncology trainee and clinical lecturer in Edinburgh, with a particular research interest in Lynch syndrome and hereditary gynaecological cancers, I immediately found the group to be not only scientifically rich, but personally supportive.
What makes EHTG special is its scale - it’s a relatively small and highly engaged community that genuinely feels like a family. From the outset, I felt included, encouraged, and nurtured. People remember your name, they follow your work, and they make space for new voices. That kind of environment is rare, and it’s been a huge part of my development as a clinician-researcher.
During my time on the Y-EHTG board, and now as Director of Education, I’ve been committed to paying that forward. I know how challenging it can be to navigate early career decisions while balancing clinical and research commitments. I want to help ensure that the next generation of EHTG members feels just as supported and seen as I did - because that sense of belonging is what keeps people engaged and helps them thrive.
SG: From your perspective, what are the biggest challenges young professionals face in the field of hereditary colorectal cancer?
AT: For young professionals new to the field, hereditary colorectal cancer can come across as being incredibly complex given the required knowledge in the basic sciences and the variability in exposure of young clinicians in the management of hereditary colorectal cancer.
The basic science knowledge is crucial for the interpretation of relevant investigations, to guide risk assessment and management of often young, potentially asymptomatic individuals. With new technologies being developed, it is important that the basis of these are well understood in order for it to be implemented appropriately.
Managing hereditary colorectal cancer can be emotionally and psychologically challenging for both the clinician and the individual and requires multidisciplinary team input from specialised services, which may or may not be easily accessible. Another challenge in this field would be developing effective surveillance and treatment strategies which minimises impact on an individual’s quality of life.
NR: One of the biggest challenges for young professionals working in hereditary cancer - especially from a gynaecological perspective - is the relative lack of an evidence base. Unlike hereditary colorectal cancer, where surveillance and management protocols are better established, the guidance for managing individuals with hereditary gynaecological cancer risk is sparse, inconsistent, or based on low-quality evidence. For those of us working in this space, it can feel like we’re building the road as we walk on it.
What’s more, researchers and clinicians in this field are often scattered across Europe, working in small, isolated teams. That’s where EHTG plays a vital role - it offers not only a platform for collaboration but also makes sure early-career professionals are included in shaping the research agenda. Without that coordination, many of us would be working in silos.
Other key challenges include securing funding in what can be considered a niche area, identifying and accessing eligible patients - particularly in mainstream settings - and balancing all of this with the demands of intense clinical training. It can be hard to prioritise research and innovation in hereditary cancer when you're also in theatre, on call, and working through exams. That’s why communities like EHTG are so essential - they help us stay connected, supported, and focused on moving the field forward.
SG: How does EHTG support and empower young clinicians and researchers to get involved in hereditary cancer care and research?
AT: EHTG offers a friendly and supportive environment for young clinicians and researchers. There is a spirit of collaboration and experienced clinicians/researchers often gladly offer advice or feedback to more junior members of EHTG. In a more formal setting, the Dragon’s Den initiative at the EHTG conference allows Y-EHTG members to pitch research proposals and gain feedback from the more senior 'Dragons'. This allows feedback and refinement of proposals in a supportive setting and facilitates discussions as well as potential collaborations. Proposals can also be advertised on the EHTG website. There is a strong track record of success with collaborative research through EHTG.
NR: EHTG stands out because of its flat hierarchy - everyone, regardless of career stage, is encouraged to contribute, lead, and collaborate. As a young clinician-researcher, I’ve found it incredibly empowering to be welcomed as a peer, with opportunities to shape real, impactful work. For example, I’ve been actively involved in guideline development - something many researchers wait years to do. That level of trust and support is rare.
Nearly all of my current collaborations in hereditary cancer have come through EHTG. These connections have led to substantial grant funding, co-authored publications, and mentorship that has been instrumental to my development. The group’s emphasis on inclusion and cross-disciplinary teamwork has genuinely changed the course of my academic career.
Beyond the formal structures like the Dragon’s Den - which is a brilliant, supportive way to get early feedback - there’s a real culture of generosity. Senior members readily offer advice, and you’re never made to feel like you’re asking a silly question. EHTG is more than a network; it’s a springboard for young researchers and a genuinely career-changing community to be part of.
SG: Are there any specific training, mentorship, or research opportunities for young members that you’d like to highlight?
AT: The Y-EHTG committee has been working on a few initiatives over the last few years. The Dragon’s Den initiative as mentioned above has been very successful. Y-EHTG members have been given opportunities to chair sessions with more experienced researchers and clinicians and are given specific sessions at our annual conference allowing the opportunity to highlight their work. We have also looked into the feasibility of setting up a mentorship scheme – surveys have been sent to gauge interest for both mentors and mentees. It is hoped that this would be tailored to individuals where possible, more importantly we would like it to be sustainable. PhD students will have opportunities for their work to be featured, encouraging collaborations and increasing the visibility of the good work being carried out by our members. Last but not least, we are very thankful for the generosity of the late Lore Möslein, without whom we would not be able to establish a number of grants for our members. The Lore Möslein Y-EHTG Travel Grant will allow Y-EHTG members to gain experience in centres of excellence, enriching their clinical and research experience and skills. We also have conference grants available to help support our members to present their work at the EHTG conference. Neil (Education lead for EHTG board) has also worked really hard to set up an EHTG podcast!
NR: There are a number of fantastic opportunities within EHTG that really help young members grow, both academically and professionally. The Dragon’s Den initiative has been a real highlight - it gave me the platform to pitch early-stage ideas and, thanks to the feedback and encouragement I received, I was able to secure significant funding. It’s a unique environment where constructive feedback and collaboration go hand-in-hand.
As Education Lead for the EHTG board, I’ve been working on developing new initiatives including a lecture series and specialist member-only educational events, designed to deepen clinical and academic understanding across key areas of hereditary cancer care. These are aimed at building both technical knowledge and a sense of shared learning across the network.
Beyond formal training, what I’ve found most valuable is the informal mentorship within the community. Through EHTG, I’ve felt completely comfortable reaching out to leaders in the field to ask for advice, feedback on grant applications, or co-authorship on manuscripts. That kind of access and generosity is rare - and incredibly powerful for someone at an early career stage.
We're also incredibly fortunate to have the Lore Möslein Y-EHTG Travel Grant and conference grants to support clinical and academic exchanges. These initiatives are helping build the next generation of experts in hereditary cancer, and I’m proud to be part of them.
SG: How do you see the role of collaboration across young societies, like with Y-ESCP and Y-EHTG, in shaping the future of colorectal care?
AT: For colorectal surgeons/trainees hoping to/or are currently working in the field of hereditary colorectal cancer, this is an opportunity to network and learn from other individuals e.g. scientists, genetic counsellors, other clinicians working in the field. It is hoped that the network can extend through the length of the careers of young society members. This will ensure ongoing opportunities for research collaborations with all stakeholders (including patients who we involve in EHTG!), discussion of complex cases and sharing of good practice leading to best practice/guideline development for excellence in colorectal care.
NR: From the perspective of gynaecological oncology, collaboration across young societies like Y-EHTG and Y-ESCP is absolutely vital. Hereditary cancer care sits at the intersection of multiple specialties - colorectal, gynaecology, genetics, pathology, and basic science—so we need mechanisms to bring these voices together early in our careers. Given that hereditary gynaecological cancer is a relatively small subspecialty, it’s incredibly valuable to have a dedicated, inclusive space like EHTG where gynaecology is not just represented, but actively integrated into wider collaborative efforts.
One of the most powerful aspects of EHTG is that all the key names in the field attend and contribute, so young members gain real access to mentorship and collaboration. The group is genuinely multidisciplinary - scientists, surgeons, genetic counsellors, and patient advocates all shape our discussions, particularly around guideline development. This ensures our outputs are comprehensive and relevant across specialties, rather than being siloed.
We also collaborate with bodies like BGCS and ESGO to make sure our gynaecological perspective is embedded in broader cancer care strategies. By building and maintaining these networks now, we are ensuring that our generation of clinicians and researchers will be well equipped to deliver joined-up, evidence-based care for people with hereditary cancers.
SG: In your opinion, what’s one area in hereditary colorectal cancer that needs more attention or innovation from the next generation of specialists?
AT: There is room for improvement for early diagnosis through identification and testing - for example, in the UK it is estimated that 95% of individuals with Lynch syndrome do not know that they have the condition. Efforts have been made to identify these individuals, including testing of all newly diagnosed colorectal cancers to identify individuals with Lynch syndrome and subsequently offering testing for family members. Current surveillance strategies based on colonoscopy, which is invasive. New technologies such as liquid biopsies, perhaps even at home testing would be an exciting concept with potential for better compliance with surveillance. Environmental factors and how this contributes to development of colorectal cancer in those with a hereditary predisposition to colorectal cancer is an interesting area which can potentially personalise risk to each individual. The development of chemoprevention agents and cancer vaccines are also exciting areas which could revolutionise how hereditary colorectal cancer is managed.
NR: From my perspective in gynaecological oncology and hereditary cancer research, one of the most pressing areas that needs greater innovation is improving early diagnosis and risk mitigation - particularly through scalable, non-invasive, and cost-effective surveillance strategies. Despite efforts like universal tumour testing for Lynch syndrome, we know that the majority of affected individuals remain undiagnosed, which represents a huge missed opportunity for prevention and early intervention.
Moving forward, we need the next generation of specialists to explore technologies like liquid biopsy, at-home sampling, and wearable diagnostics - not just for detection, but to truly personalise surveillance. These tools could reduce the burden of invasive procedures like colonoscopy, improve patient compliance, and potentially offer earlier risk stratification. In parallel, there’s a clear need to expand chemoprevention strategies and harness emerging vaccine platforms to reduce cancer incidence in high-risk populations.
Finally, for those who do develop cancer, we need to tailor immunotherapy more effectively based on hereditary profiles. Hereditary cancers, especially those with mismatch repair deficiencies, offer a unique biological landscape to refine immunotherapeutic approaches - something that could dramatically improve outcomes.
The future of hereditary colorectal cancer care lies in this full-spectrum, personalised approach - from prevention to precision treatment.
SG: Have you seen a shift in how hereditary colorectal cancers are approached in multidisciplinary teams or through personalised care?
AT: There has definitely been a focus on identification of Lynch related cancers through universal tumour testing at time of CRC detection, and ensuring MSI status is known before deciding on treatment options. There is excitement around new non-surgical management of Lynch-related rectal cancers with the approval of drugs such as dostarlimab, and a greater effort to train MDTs in genetic related cancer care.
NR: Absolutely - there’s been a noticeable shift toward more personalised and multidisciplinary approaches to hereditary colorectal and associated cancers. In the UK, for instance, we now have dedicated national guidelines addressing ovarian cancer risk reduction, including broader access to germline testing and the offer of risk-reducing surgery at earlier thresholds. Endometrial cancer is now universally tested for Lynch syndrome - something that has evolved during my own career - and we’ve seen the establishment of national registries and screening programmes in England, helping to centralise and standardise care.
Perhaps most transformative has been the rise of immunotherapy, which has changed the treatment landscape for many Lynch-related cancers, particularly endometrial and colorectal. Drugs like dostarlimab have opened the door to curative non-surgical approaches in selected patients - something unthinkable even a decade ago.
However, while progress has been significant, inequity remains a major issue. In Scotland, where I work, and in other parts of Europe, these advances are not yet embedded in clinical practice. Implementation varies widely, and ensuring equitable access to diagnostics, prevention, and precision treatment is one of the biggest ongoing challenges. Closing that gap must be a priority as the field continues to evolve.
SG: What excites you most about the upcoming Tripartite Colorectal Meeting in 2025, and what would you hope to see featured in the programme?
AT: I am looking forward to gathering in person this year! Paris is a great city and has a lot to offer. There is usually a great educational programme at the Tripartite meetings but personally, it would be great to have a session on hereditary colorectal cancer and emerging technologies featured in the programme.
NR: As a gynaecologist, what excites me most about the upcoming Tripartite Colorectal Meeting in 2025 is the opportunity to strengthen cross-specialty collaboration - particularly around cancer care. Some of the most rewarding work I’ve done has involved partnering closely with my colorectal colleagues to deliver maximal surgical effort and optimal cytoreduction for patients with complex cancers. These cases highlight the necessity - and impact - of true multidisciplinary teamwork.
I would love to see more of this collaborative ethos reflected in the programme. While the educational content is always excellent, it would be fantastic to have sessions that explore joint approaches to surgery, shared innovations in hereditary cancer care, and emerging technologies that can transform how we approach surveillance and treatment across specialties.
A strong message of collaboration is vital - not just between colorectal and gynaecological teams, but across genetics, oncology, surgery, and patient advocacy. Meetings like Tripartite are a powerful platform to drive that message forward and shape the future of personalised cancer care.
SG: Lastly, what advice would you give to young surgeons or researchers who want to get more involved in hereditary tumour work or join EHTG?
AT: Do it! We would love to have you on board. Subscribe to our newsletter at https://linktr.ee/ehtg.org for the latest information and opportunities available!
NR: My message is simple: do it - get involved. Joining EHTG has genuinely changed the course of my career. It has led to lifelong collaborations, enduring friendships, and opened doors I didn’t even know existed. As a young researcher or surgeon, you’ll find EHTG to be an incredibly inclusive and dynamic community where your ideas are welcomed and your contributions valued.
It’s a place where multidisciplinary innovation thrives - whether you're working in the lab, clinic, or operating theatre. And more than any other meeting, EHTG is the one I most look forward to each year. It’s not just a conference; it’s a professional home.