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For the first time, thousands of cancer patients from Black and minority ethnic backgrounds will benefit from an enhanced genetic test offered by the NHS. The new screening expands the panel of DPYD gene variants from four to five, directly addressing a long‑standing bias that left non‑white patients vulnerable to dangerous chemotherapy side‑effects. In England, patients slated for chemotherapy undergo a genetic check that can guide dose adjustments and mitigate adverse reactions such as mouth sores, hair loss, nausea, fatigue, and, in severe cases, death. Up to 40% of the 38,000 individuals receiving fluoropyrimidine‑based chemotherapy each year experience a harmful drug reaction. Previously, the test only targeted four DPYD variants common in people of European descent, meaning many Black patients received inaccurate “all‑clear” results. The addition of a fifth variant—more prevalent among African, Caribbean and other minority groups—means clinicians can now identify patients at risk who were previously missed. Since its rollout at Manchester University NHS Foundation Trust last September, three minority‑ethnic patients have had their initial chemotherapy doses adjusted, lowering their chance of a potentially fatal reaction. Dr Veline L’Esperance, senior clinical adviser at the NHS Race and Health Observatory, called the change “tangible results for patients who have historically been left behind.” She emphasized that the update shifts the discussion on ethnic health inequality from rhetoric to actionable care. Prof Habib Naqvi, chief executive of the NHS Race and Health Observatory, described the development as a “groundbreaking outcome” for chemotherapy safety, while noting that ethnic minorities remain under‑represented in genomic research and biobanks. He warned that broader inclusion is essential for the promised benefits of precision medicine to reach all communities. Prof Dame Sue Hill, chief scientific officer for NHS England, highlighted the significance of discovering the fifth variant: “Personalising chemotherapy based on genetics can save lives and reduce harmful side‑effects, especially for patients of African ancestry.” She added that the North West NHS Genomic Medicine Service has already demonstrated the practical impact of this approach. These steps come amid broader evidence that minority patients in the UK face longer diagnostic waits, more GP visits before a cancer diagnosis, and lower perceived support during treatment. The expanded DPYD test represents a concrete effort to close those gaps and ensure equitable, science‑driven care for all cancer patients.