New recommendations to reduce the underutilisation of pathology testing
The Royal College of Pathologists of Australasia (RCPA) has announced new recommendations to reduce underutilisation in pathology testing in order to improve patient care. Reviews of published evidence estimate that, on average, the levels of underutilisation in pathology testing is substantially more prevalent (44.8%) than levels of overutilisation (20.6%).
President of the RCPA, Dr Michael Harrison, said,
“The most common areas of underutilisation of pathology testing are poorly recognised and unfortunately widespread, but despite this, it remains understudied. It’s important to ensure that the appropriate tests are offered to patients. The new recommendations aim to guide requesting clinicians to use pathology tests in order to improve patient care and enhance early diagnosis however it is also important to raise awareness amongst patients of the necessary use of tests. Often patients are unsure what questions to ask when at the GP, so it’s useful for them to be aware of the tests that are available and where and when their use is relevant to them.”
Examples of recommended testing guidelines include:
- Blood lipids should be tested every five years in the context of an absolute cardiovascular disease (CVD) risk assessment in adults aged from 45 years or, for Aboriginal and Torres Strait Islander peoples aged from 35 years. This requires testing for cholesterol, triglycerides and HDL cholesterol.
- Women aged between 25 and 74 years, should be screened for the Human Papillomavirus (HPV) every five years to detect early cervical cancer.
- In the normal risk population, a faecal occult blood test should be conducted every two years to detect bowel cancer, from 50 years of age until 75. Patients with a high risk should commence testing at an earlier age.
- Prostate-specific antigen (PSA) testing should be offered to men every two years from age 50 to age 69 in order to detect early prostate cancer. For men who are at high risk, commence testing earlier.
- Sexually active people aged 15 -29 years should be tested for chlamydia every 12 months.
- Pre-conception testing for haemoglobinopathy carrier status should be conducted in at-risk populations.
- Testing for Ferritin should form part of antenatal work-up in all pregnancies to detect iron deficiency.
- To avoid incorrect labelling of gluten intolerance, all patients being considered for this diagnosis should be tested for anti-gliadin antibodies (as well as gastroenterology referral).