The idea of starting the year with a clean slate, particularly a clean bill of health, is appealing. We run through five health tests that might be worth considering.

The type 2 diabetes, or HbA1c, test

A relatively new test, the HbA1c test looks at ‘glycated haemoglobin’ in your body, averaged over the last three months, to determine if you have diabetes, prediabetes or healthy levels of HbA1c.

With 1.2 million Australians living with diabetes, a further 500,00 suspected of having undiagnosed diabetes and with the condition projected to grow to 3.5 million by 2033, it’s a real spectre on the health horizon. Someone can live with diabetes for 7 years before any symptoms become apparent, causing damage to the body in the meantime.

Take the 2-minute AUSDRISK diabetes assessment to learn if you might be at risk and need to book in for a test.

The skin cancer, or melanoma, test

Australians have the highest rates of skin cancer in the world, and melanoma is the third most common cancer in Australia, and two-thirds of Australians will be diagnosed with skin cancer by the time they’re 70.

A visit to the doctor or skin specialist to check spots and for other symptoms is your first port of call. If required, the doctor may perform a biopsy to test for any suspected skin cancer.

Bowel cancer screening

Every year 17,000 Australians are diagnosed with bowel cancer, but the good news is that bowel cancer is one of the preventable cancers, meaning with changes to diet and lifestyle, the dangers can be reversed or mitigated.

Of those diagnosed with bowel cancer, 93% are aged over 50. If detected early, 9 out of 10 bowel cancer cases can be successfully treated. And in a stroke of further good fortune, the Australian government runs a free bowel screening test program, sending a testing kit to your house, no less, which you can conduct and return at your own convenience.

Cholesterol test

Cholesterol is no good for the old heart and brain, so if you’re over 45 you want to check that out – particularly if high cholesterol and heart disease run in the family. For those under 45, other risk factors include smoking, excess weight, diabetes, high blood pressure renal failure, or being of Aboriginal or Torres Strait Islander descent.

A cholesterol test involves taking a blood sample and looking for LDL-C, a bad cholesterol (there are good ones too) which collects in the walls of blood vessels.

STI and related tests

No, young people do not escape testing. If you are sexually active you might want to consider testing for chlamydia, syphilis, or gonorrhoea, as well as the three H’s: human papillomavirus, HIV and hepatitis.

STIs are on the rise in Australia and often symptoms will be missed. If not detected and treated the health effects can be significant. More detail on how these tests work can be found here.

While GPs are often the first port of call for someone concerned about a medical condition, and where test referrals are made, it’s the pathology lab where a diagnosis is determined.

‘There are plenty of health conditions out there of concern,’ says Victorian pathologist, Dr David Clift ‘but the good news is that a lot of these conditions are preventable and treatable.’

‘Certainly, the five conditions mentioned here are preventable. If you haven’t had a test ever or for a while and have concerns, it’s good to know with Australia’s leading-edge pathology sector that you can have a simple test and set your mind at ease for the coming year.’

The post 5 health tests to start 2019 on the right footing first appeared on Know Pathology Know Healthcare.

• Chlamydia trachomatis (commonly referred to as Chlamydia)
  • Symptoms
  • Testing
  • Treatment
• Syphilis
  • Symptoms
  • Testing
  • Treatment
• Gonorrhoea
  • Symptoms
  • Testing
  • Treatment

Sexually Transmitted Infections (STIs) cover a range of medical conditions; including chlamydia trachomatis (there are non-STI species as well), syphilis, gonorrhoea, genital herpes, hepatitis, HIV infection/ AIDS.

The STIs being discussed in this article will be Chlamydia trachomatis, syphilis, and gonorrhoea. For information on HIV / AIDS and Hepatitis click on the supplied links.

Chlamydia trachomatis (commonly referred to as Chlamydia)

Symptoms

Amongst the most common STIs in Australia, sexually transmitted chlamydia is caused by the bacteria Chlamydia trachomatis and effects both sexes. One of the issues with chlamydia is that for 50% of men and 70-80% of women there aren’t always noticeable symptoms.

Symptoms may include pain during urination, and an unusual discharge from the penis, vagina or rectum. Women may experience bleeding between their periods or following intercourse. The only way to know for certain if you have chlamydia or another STI is to be tested specifically for it.

If left untreated, it can have serious effects, including pelvic inflammatory disease and sterility.

Testing

A simple urine test, and in some cases for women a swab test will determine if you have chlamydia. Samples are taken to a pathology lab where they are tested using Polymerase Chain Reactions (PCR) techniques. These molecular methods are extremely sensitive and highly specific and can be performed rapidly in a few hours. PCR testing looks at short sections of DNA and makes large numbers of them in a thermocycler to analyse. A billion copies of the DNA can be produced within a few hours.

If you have had unprotected sex or believe you may have contracted an STI you should visit your GP or medical clinic and discuss having a test.

Treatment

Chlamydia can be cured with a course of antibiotics, as recommended by a doctor.

Syphilis

Symptoms

Syphilis is caused by the bacteria Treponema pallidum and although traditionally somewhat rare in Australia, the numbers of cases, in both men and women, are dramatically increasing in recent years. If left untreated it can cause serious health problems. Syphilis overwhelmingly effects men – at seven times the rate of women – and is increasing in men who have sex with men and people with HIV/ AIDS.  However, it can have devastating effects on unborn babies if acquired during pregnancy.

Initial symptoms include a painless sore on the genitals or around the rectum or mouth which disappears. Later symptoms can include a body rash, including on the hands or soles of the feet. If left untreated it can spread through the body and cause significant damage to organs, the cardiovascular system, the brain and the nervous system.

Testing

There are a number of tests, known collectively as Syphilis Detection Tests, that are used to detect syphilis. Most commonly, the test involves taking a blood sample, sometimes from a swab of the affected ulcer, and on rare occasions through a spinal tap. As with chlamydia samples are taken to a lab where they are searched for antibodies or by PCR to detect the bacterial DNA. The bacteria is not able to be cultured in a laboratory.

If you have engaged in high-risk activity or are pregnant you should consult your doctor about having a test.

Treatment

Like chlamydia, syphilis can be cured with a course of antibiotics.

Gonorrhoea

Symptoms

Colloquially known as ‘the clap’, gonorrhoea is caused by the bacteria Neisseria gonorrhoeae and can affect the urethra, cervix, anus, throat or eyes. It is spread by engaging in unprotected sex with someone infected with the condition.

Often asymptomatic, untreated gonorrhoea can lead to sterility in both sexes and other health complications. If symptoms occur they can include swollen testicles, vaginal discharge or bleeding between periods, or pain during urination. It can also be passed on from a pregnant mother to her baby during birth, potentially causing eye infection and blindness.

Testing

A gonorrhoea test involves taking a sample from a swab or brush of cells, vaginal or penile secretions, a urine sample, and sometimes a swab from a non-genital area. As per chlamydia and syphilis, the lab will test using PCR on the urine and grow bacteria in the laboratory. In recent years these bacteria have become increasingly resistant to the majority of antibiotics which were once effective in treating this infection, therefore it is very important to get samples where the bacteria can be cultured and then tested for sensitivity to antibiotics. The test is recommended for sexually active women 25 or older or who are pregnant, and yearly for men who have sex with men.

Treatment

Gonorrhoea can be treated with antibiotics.

If you believe you may have contracted any of the above, or any other STI, consult your doctor or medical clinic for advice on what to do.

The post What are STIs and how to test for them? first appeared on Know Pathology Know Healthcare.

First recorded in 15^th century Naples, syphilis – also known as ‘The Great Pox’ – devastated Europe in the 16^th and 17^th centuries and was almost eradicated in the early 2000s but has suddenly flared up again in remote Australia at an alarming rate.

Far from being innocuous the Sexually Transmitted Infection (STI) spreads lesions and sores across the body and is particularly problematic for pregnant women. If contracted, the baby of a pregnant mother has a 50 per cent chance of survival, and if they do survive, they risk blindness, deafness and cognitive issues.

Since two cases of syphilis were diagnosed in Queensland a decade ago, it is has now come to affect thousands of patients, notably in Indigenous communities.

Mr Wyatt approved the immediate dispatch of 10,000 test kits – 3,000 to Townsville, 3,000 to Cairns, and 4,000 to Darwin – with a further 52,000 ordered and sent on.

What’s the immediate plan?

Because syphilis can be in the system for six months before symptoms arise, the infection can be spread unwittingly through sexual activity.

This puts a premium on rolling out syphilis tests. A syphilis TP rapid test takes around 15 minutes to deliver a result. Early detection means treatment is not only more manageable for those who have contracted it, but also helps prevent its further spread.

Director of Sexual Health at Cairns Sexual Health Service, Dr. Darren Russell, says if someone is found to have syphilis, treatment can begin straight away.

‘Early syphilis is treated with a single injection of penicillin, which is highly effective at curing the infection. Within days, the symptoms resolve and the person is no longer infectious.’

In the short to medium term, communication and education materials will be rolled out to explain the potential impacts of syphilis and how to avoid contracting it.

So, what’s behind the rise?

‘Changes in sexual behaviour since the advent of better treatments for HIV, combined with a high degree of mobility, mean that syphilis has been able to take off in this population, notably in the gay community. Heterosexuals are also affected in many countries, particularly those in disadvantaged and marginalised groups.’

But syphilis is not the only STI on the increase in Australia.

The Kirby Institute’s 2017 Annual Surveillance Report into HIV, viral hepatitis, and STIs found that while HIV rates remained stable from 2012-2016 after an 8 per cent spike in the year preceding, gonorrhoea rates increased by 63%, while syphilis increased by 107% in the same period.

There have been several ideas advanced to explain the reasons for the influx of STIs; from the uptake of online dating sites which expand sexual encounters, the low usage of condoms among young men, the greater degree of travel and sexual experimentation tied in with that, and the perhaps more lax approaches to safe sex tied up with advances in HIV treatment medications.

The post What’s behind Australia’s syphilis outbreak and the rise of STIs? first appeared on Know Pathology Know Healthcare.