2026 approaches, and the field of pathology finds itself at a pivotal moment shaped by scientific momentum, new technologies, and persistent challenges that continue to influence diagnostic practice. The past year brought significant advances – from major steps forward in genomic medicine to wider adoption of AI and digital workflows – but it also highlighted areas where continued focus and collective effort are essential.
Over the past 12 months, genomics entered a new phase, with long-read sequencing becoming increasingly integrated into clinical workflows. Its ability to resolve complex and repetitive regions of the genome has already begun influencing diagnostic algorithms, particularly for inherited neurological diseases. One of the most widely discussed achievements of 2025 was the milestone in slowing Huntington’s disease progression, which energized global efforts to tackle other repeat expansion disorders. Following this breakthrough, we connected with Russ Lebovitz, discussing the challenges in neurodegenerative disease diagnostics. This success has underscored the critical role of technologies capable of analzsing regions that traditional approaches cannot.
Digital pathology and AI adoption also gained momentum. Many laboratories moved beyond exploratory pilots and began incorporating digital and computational tools into routine workflows. Prasanth Perugupalli provided insights into digital adoption gains in laboratories across the world. Rather than chasing novelty, the focus shifted toward validation, reproducibility, safety, and real-world utility.
Pathologists continue to play an important role in shaping governance frameworks and ensuring these tools are used responsibly. Alongside this initiative, we’ve heard from a plethora of professionals in 2025, including Marilyn Bui and Ghulam Rasool’s six essential pillars of progress in generative tools; and Derek Welch’s examples of how pathology data can provide revenue generation.
In diagnostic microbiology and infectious disease, improved imaging methods, more sophisticated molecular panels, and expanded genomic surveillance capabilities are allowing laboratories to respond to emerging pathogens with greater precision. These advancements reinforced the importance of adaptable, evidence-driven diagnostic systems.
Despite these successes, several long-standing challenges remain. Workforce shortages continued to intensify across multiple regions, raising concerns about the sustainability of diagnostic services and emphasising the need to rethink training pathways and retention strategies. Early-career pathologists – such as Alae Kawam – repeatedly voiced the importance of meaningful mentorship, clearer competency frameworks, and structured exposure to digital and computational skills.
Equity in diagnostics is another area requiring attention. The underrepresentation of global populations in genomic datasets continues to affect interpretation accuracy for many patients. Encouragingly, several countries launched or expanded national pangenome initiatives in 2025, including the assembly of the first Arab human pangenome, signalling a broader commitment to building reference datasets that better reflect human diversity.
As the pace of innovation accelerates, the profession should remain steadfast in protecting foundational priorities. Quality and patient safety remains central in every technological adoption. Pathologists’ expertise will continue to be essential for validating new tools and interpreting increasingly complex data. Ensuring equitable access to diagnostics must remain a guiding principle. And as diagnostics become more deeply intertwined with computational science, collaboration across disciplines will be key.
The past year demonstrated, once again, that pathology is a forward-looking specialty – one that thrives on scientific discovery, technological innovation, and a deep commitment to improving patient care. In 2026, pathologists and laboratory professionals are well-positioned to advance precision medicine, shape how new technologies are used, and continue advocating for quality, access, and equity. The future of diagnostics will depend on both the tools we adopt and the people who guide their use, and in the year ahead, that leadership will matter more than ever.
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