The organisation is launching a nationwide healthcare provider campaign about supporting patient choice in cervical screening. The campaign intends to educate providers about the reliability of HPV self-collection and encourage them to offer self-collection as a choice to all eligible cervical screening patients. This provider campaign begins ahead of a nationwide patient-facing campaign set to debut in September, also funded by the Australian Government, promoting the HPV self-collection option in cervical screening.

Throughout the provider campaign, GPs are being encouraged to contact their pathology providers to:

• confirm that they can process self-collected vaginal samples, or
• confirm that they are able to refer self-collected vaginal samples to an accredited laboratory, if necessary, and
• order the correct collection device and other consumables for offering self-collection, and
• confirm any collection, handling and transport requirements.

The most commonly used device for self-collection in the National Cervical screening Program is a Copan FLOQswab (red top) flocked swab 552C or 552C.80.

Self-collected samples are taken from the vagina, whereas samples from clinician-conducted speculum exams are taken from the cervix. All routine (asymptomatic) cervical screening participants are eligible for self-collection, including patients who are pregnant¹ and those with immune deficiency. If HPV is found, follow-up is required.

Self-collection is just as sensitive for the detection of HPV and CIN2+/adenocarcinoma in situ as a clinician-collected sample² and can help overcome screening barriers in under-screened groups (e.g., privacy/modesty concerns, fears of discomfort and pain, previous trauma, etc.). Currently, over 70% of cervical cancer cases occur in people who have never screened or are overdue. Therefore, self-collection can address disparities by helping engage those who would otherwise not participate in screening—but only if they are provided the choice to do so.

If you are a healthcare provider and want to get up to speed on HPV self-collection and cervical screening, you can visit campaign resource hub to find webinars, podcasts, provider resources, and other CPD opportunities.

You don’t have to be a cervical screening provider to support the campaign – to spread the word about the importance of supporting the choice, you can check out the stakeholder toolkit

References:

1. Cancer Council Australia. 14. Screening in pregnancy [Internet]. 2022. Available from: https://www.cancer.org.au/clinical-guidelines/cervical-cancer/cervical-cancer-screening/screening-in-pregnancy
2. Arbyn M, Smith S, Temin S, Sultana F, Castle P. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. Bmj. 2018 Dec 5;363.

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According to Diabetes Australia, 10,249 Australians living with diabetes are now undergoing kidney replacement therapy, including dialysis, each year.

More than 1.5 million Australians live with diabetes, which can lead to serious complications including kidney disease.

With diabetes patients on dialysis accounting for approximately 5% of all hospitalisations, this has a significant impact on hospital capacity countrywide.

Earlier detection of kidney disease could save the Australian economy an estimated $500M per annum.²

Pathology Awareness Australia (PAA) ambassador Professor Graham Jones, a chemical pathologist who specialises in pathology testing for kidney disease, is encouraging people living with diabetes to get regular kidney checks to prevent the onset of kidney disease. Prof Jones said:

“Laboratory tests for the detection of kidney disease are crucial as it does not show clinical symptoms in its initial stages. For people living with diabetes, regular blood and urine tests play a vital role in identifying and monitoring from early onset.

“Staying proactive by scheduling GP check-ups is important to ensure timely diagnosis of kidney disease. If caught early, effective measures can be taken to prevent or slow down further kidney damage. Neglecting the condition can lead to kidney failure, dialysis, and in some cases, a kidney transplant may be required.”

Simple blood and urine checks, along with blood pressure checks, can effectively monitor kidney function and allow for early treatment, reducing the chance that people living with diabetes will require dialysis or kidney transplant.

While more than 300 Australians with diabetes currently receive a kidney transplant every year, a huge 2,024 people living with diabetes in Australia die from kidney disease each year, a concerning number for a mostly preventable condition.

PAA, Diabetes Australia and Kidney Health Australia say it is important for people with diabetes to work with their diabetes care teams and schedule annual kidney health checks.

Justine Cain, Group CEO of Diabetes Australia, said:

“More than 10,000 Australians living with diabetes are currently undergoing kidney replacement therapy. Most kidney failure can be prevented with early intervention; however, just under a quarter (23%) of people are getting their kidneys checked within recommended timeframes.”

Kidney disease occurs when the filters inside the kidneys become damaged and can no longer filter the blood properly. This can cause waste products to build up in the body and may progress to kidney failure, which in turn requires dialysis or a kidney transplant for survival.

In its earlier stages, kidney disease can be managed by various lifestyle changes, along with medication which can slow progression. Chris Forbes, CEO of Kidney Health Australia, said:

“We are championing early detection and prevention of progression of kidney disease for all Australians, with a special focus on those at greatest risk – those living with diabetes, cardiovascular disease, and high blood pressure.

“Kidney Health Australia is leading the fight to identify the 1.8 million Australians unaware they have kidney disease and help them, and their families manage the condition more effectively from start to end. We’ve developed a holistic approach that goes beyond merely screening individuals. Early diagnosis, better treatment and support post-diagnosis go hand in hand for achieving best outcomes.

Our recent Deloitte Economics Access report exposes kidney disease as a national emergency, costing the Australian economy $9.9 billion each year, including $2.3 billion in direct costs to the health system. Now is the time to invest in kidney health, for everyday Aussies, the economy, the healthcare system, and the environment.”

Diabetes was an underlying or associated cause of death in more than 2,000 people living with chronic kidney disease in Australia in 2020.³

In the coming years, this is expected to increase due to the rising prevalence of type 2 diabetes and the strong association between it and diabetic kidney disease.⁴

According to PAA pathologist Prof Jones, regular laboratory testing for kidney damage is a key factor to improve the health of people living with diabetes.

References:

1. https://www.diabetesaustralia.com.au/wp-content/uploads/2023-Diabetes-Related-Kidney-Disease-Report-1.4-DIGITAL.pdf
2. https://kidney.org.au/uploads/resources/Changing-the-CKD-landscape-Economic-benefits-of-early-detection-and-treatment.pdf
3. Australian Institute of Health and Welfare (2023) Chronic kidney disease: Australian facts, AIHW, Australian Government, accessed 11 June 2023.
4. Reutens AT. Epidemiology of diabetic kidney disease. Med Clin North Am. 2013;97(1):1-18

Image credit: Robina Weermeijer on Unsplash

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Following the announcement by the Medicines Services Advisory Committee (MSAC) in 2022, people who are planning to start a family will now have expanded access to genetic carrier screening, which began in November 2023.

This testing provides people with crucial information that can significantly impact their reproductive choices.

The three conditions covered by the expanded testing are cystic fibrosis, spinal muscular atrophy, and Fragile X syndrome. Approximately 1 in 20 people are carriers of one or more of these conditions¹. While varying in severity, these conditions, are all associated with significant health challenges, making early identification vital for making informed reproductive choices.

Genetic carrier screening is a powerful tool for identifying individuals at risk of carrying genetic changes associated with inherited conditions.

Pathology Awareness Australia (PAA) ambassador and genetic pathologist, Dr Melanie Galea, emphasises the importance of this testing:

“The three gene carrier screen enables individuals and couples to assess their risk of three common inherited conditions occurring in their children.”

“These three conditions have been chosen because of the severity of the clinical phenotypes and because they are common within the population.”

• Cystic fibrosis: Disorder that affects the lungs, pancreas, and other organs. Symptoms include frequent lung infections, malabsorption and shortened lifespan.
• Spinal muscular atrophy (SMA): Affects the nervous system and causes muscle weakness and atrophy. SMA is the leading genetic cause of infant mortality.
• Fragile X syndrome (FXS): Causes intellectual disability, behavioural and learning challenges. FXS is the most common inherited cause of intellectual disability.

Genetic carrier screening can help identify carriers of the genetic changes that result in these conditions. The expansion will significantly enhance the accessibility of these tests, potentially saving many families from the heartache of unknowingly passing on a serious genetic condition to their children.

Upon receiving results that identify them as carriers of a genetic condition, individuals and couples will have a range of options to consider, Dr Galea emphasised:

“We would recommend genetic counselling for at-risk patients identified by this screening to discuss the results, their implications and the reproductive options that are available. These options may include access to preimplantation genetic diagnosis through IVF, the use of donor gametes, prenatal diagnostic testing during pregnancy, and accepting the risk.”

In October 2017, a heartbreaking story came to light when Mackenzie Casella lost her battle with spinal muscular atrophy (SMA) at just seven months old. Her parents embarked on a quest called Mackenzie’s Mission². Their goal was clear: to make genetic carrier screening a standard and cost-free service for all Australian families preparing for parenthood. Their tireless efforts have been a driving force behind this funding allocation for expanded genetic carrier screening in Australia.

Dr Galea further added, “Reproductive carrier screening has become a mainstream test and has been available for several years in clinical laboratories across the country. The introduction of these rebates will make this testing more accessible to help inform reproductive decision making.”

The reproductive carrier screen test (CF, SMA and FXS) will be reimbursed under the Medicare Benefits Schedule starting November 2023³.

Quotes attributable to The Hon Mark Butler MP, Minister for Health and Aged Care:

“These new Medicare rebates for cutting-edge genetic testing will strengthen Medicare and make healthcare more affordable and available.” “The new Medicare rebate for reproductive carrier testing will provide confidence to women and their partners as they plan a pregnancy and start a family.”

References

1. https://www1.racgp.org.au/newsgp/clinical/three-condition-genetic-carrier-screening-to-becom
2. https://www.mackenziesmission.org.au/what-is-mackenzies-mission/ 
3. https://www.rcpa.edu.au/getattachment/2c1af2e1-b936-4948-bbbb-e1239c557cd4/Reproductive-screening-for-fragile-X-syndrome,-(1).aspx 

Image credit: Garrett Jackson on Unsplash

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PICCSI employs self-collected human papillomavirus (HPV) testing for Fijian women, to rapidly detect the virus that causes the majority of cervical cancers via point-of-care PCR testing.
Test results are returned within 45 minutes, showing whether a patient is HPV positive for a high-risk type of HPV. For those who test positive and require treatment, this can be provided on the same day.

The treatment removes pre-cancerous cells and is administered by the skilled Australian volunteer team, spearheaded by Melbourne-based obstetrician gynaecologist Dr Nicola Fitzgerald.

Dr Fitzgerald’s volunteer team is comprised of gynecologists, midwives, gynecology nurses, gynecologist trainees, and a GP, along with non-clinical administration staff.

Dr Fitzgerald commented on the importance of pre-cancerous cell detection and removal for Fijian women,

“In countries like Australia, cervical cancer diagnoses are more accessible, and treatments like chemotherapy and radiation are available. However, in the Pacific region, options for radiation as a treatment option are limited, unless individuals can afford to travel abroad to receive treatment.

This means that many women in the Pacific do not receive adequate treatment following a cervical cancer diagnosis.

This was the primary driver behind the development of PICCSI. It allows us to detect and treat women in the pre-cancerous stage, before they develop cervical cancer and the need for radiation or chemotherapy is required. In this way, the project has transformed access to cervical health services for Fijian women.”

This year’s PICCSI program took place in five different rural centres across Fiji from 7th-11th August, with a total of 302 Fijian women being screened for cervical cancer. The testing resulted in a positive HPV rate of 17%, and 25% of those women received pre-cancerous cell removal treatment.

Partnering with the Australian Centre for the Prevention of Cervical Cancer (ACPCC), who provide one of the testing machines for the program, and local partners Fiji National University and the Department of Obstetrics and Gynaecology at Lautoka Hospital, PICCSI addresses critical gaps in cervical cancer prevention and treatment in the Pacific region.

Local women aged 30-50 years were invited to be screened, with three PCR testing machines provided to the program by ACPCC and the Fiji Ministry of Health, allowing 12 cervical samples to be tested per hour.

In addition to providing PCR technology, ACPCC provides ongoing pathology services, training, technical support, and result interpretation to the program on a volunteer basis.

PICCSI aims to address several key challenges faced by Fijian women in accessing the healthcare they need, such as travel and financial considerations, healthcare workforce capacity, and infrastructure.

John Crothers, Executive Officer of Pathology Awareness Australia commented, “Collaborating with our Pacific neighbours to combat cervical cancer is a commendable initiative. Cervical cancer remains a significant health challenge, particularly in regions with limited resources and access to advanced healthcare.

By joining forces, sharing expertise, and implementing preventative measures such as HPV vaccination and early screening programs, we can make a substantial impact on reducing the burden of this preventable disease in countries such as Fiji. It’s an opportunity to not only save lives, but also to strengthen the bonds of solidarity and support within our broader healthcare community.”

Prior to this screen, test and treat program, there could be delays of up to 8 weeks in obtaining test results. Combined with transportation and family challenges, this has contributed to high rates of patients who received abnormal results remaining untreated.

Dr. Fitzgerald emphasised, “There is an urgent need to improve cervical cancer screening and treatment accessibility for Fijian women. At PICCSI, we are laying the foundation for a broader Pacific-wide screening program. Our objectives extend beyond immediate care, as we aim to boost awareness of cervical cancer screening, involve local practitioners, and gather data to advocate for a nationwide screening program in Fiji.”

PICCSI’s impact has been profound since its inception in 2018, delivering prompt testing, diagnosis, and treatment. In each five-day mission, 300-400 women are screened, with an average of 10-15% requiring treatment each time. By offering immediate results, follow-up rates have significantly improved compared to delayed result models.

Dr. Fitzgerald concluded, “PICCSI showcases the collaborative spirit of healthcare professionals across borders. By providing accessible, immediate, and sustained care, we are contributing to the larger goal of cervical cancer prevention in the Pacific.”

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The post Pathologists urge Australians with family history of breast, ovarian and prostate cancer to know their risk first appeared on Know Pathology Know Healthcare.

The study looked at a 15-week period in 2020-2021 and compared pre-pandemic mortality rates with an equivalent period in 2019, accounting exclusively for non-COVID-related deaths.

There were 30,118 non-COVID-19-related deaths in people with diabetes in the 2021 period compared to 27,132 deaths in the 2019 period, representing an 11% increase. The data also captured participation in recommended health checks for people with diabetes.

In 2020-2021, only 853,669 (27%) of the cohort received the annually recommended 8 care processes for people living with diabetes. This was 45 per cent less than 2019-2020, when 1,547,240 people (48%) received all 8 care processes.

COVID-19 containment measures made it harder for people living with diabetes to access regular health checks. As a result, 693,571 people may have missed some of the important health checks and tests to effectively monitor their condition, and reduce the risk of complications, including heart disease and amputations. People with chronic conditions such as diabetes, kidney disease and heart disease need regular pathology tests to manage their condition.

Chair of Pathology Awareness Australia, John Crothers said: “This highlights concerns that we have here in Australia on the impact of reduced participation in healthcare resulting from COVID containment measures during the pandemic. The tragedy of this increase in deaths tells us we need better awareness of the importance of healthcare participation across the board, especially for people with chronic conditions, or at risk of developing them.”

Diabetes Australia Group CEO Justine Cain added, “People with diabetes are at a much higher risk of serious illness from COVID-19 and many people took appropriate steps to limit their risk of exposure to the virus. However, this led to many people missing important health checks.”

Due to the comparable nature of the two countries, and the potential implications beyond diabetes to other chronic conditions the study is worrying for Australian health professionals.

In Australia, routine pathology testing dropped by around 40 per cent across the board at the start of the pandemic and there is concern that many who delayed testing have not yet caught up.

Four of the eight annually recommended care processes listed in the study are pathology tests. These include a glycated haemoglobin check known as HbA1c. This blood test is used to help diagnose and monitor people with diabetes, alongside a cholesterol blood test that looks at the levels of cholesterol and other fats in the blood, a serum creatinine blood test, and urine albumin which are both used to check kidney function.

Chemical Pathologist and PAA ambassador, Graham Jones said: “This study can also be seen to have implications beyond the effects of the COVID epidemic, that for people with diabetes, the best health outcomes require access to full healthcare services, of which regular pathology testing are a major component.”

This study highlights the increased risk of mortality in those living with diabetes who did not receive all eight care processes in one or both of the previous two years.

Diabetes Australia is urging people living with diabetes to keep up to date with their routine management and monitoring diabetes checks, and to not put them off.

Ms Cain said, “We know living with diabetes can be tough and there are a range of different health checks people need to have to stay on top of their diabetes. However, we want to encourage people with diabetes to connect with their diabetes health team. Most diabetes-related complications are preventable if detected early which is why regular health checks are so important.”

Since the beginning of the COVID-19 pandemic, patient diagnosis and monitoring has been severely impacted by Australians missing their health appointments and routine checks.

If patients prefer not to attend health appointments in person, it is possible for a GP to request pathology tests based on a telehealth appointment.

The post Regular health checks encouraged for those living with diabetes first appeared on Know Pathology Know Healthcare.

Cervical screening participation among those with a cervix

The National Cervical Screening Program monitoring report 2021 from the Australian Institute of Health and Welfare (AIHW) shows that over the 3-year period 2018-2020 only 56% of eligible people took part in cervical screening tests.¹

The highest participation rate was for those aged 45-49 at 61%, but for those aged 65-69 participation was 55%, and only 27% of those aged 70-74 took part in cervical screening.

While it is unclear how much of an impact the pandemic has had on cervical screening uptake, routine healthcare participation was significantly affected, with pathology testing rates dropping by around 40 per cent² in the first months of COVID-19 restrictions.

The National Cervical Screening Program changed from the ‘pap test’ screening model, with those aged 20-69 being tested every 2 years, to the renewed program where people with a cervix are advised to test every 5 years from age 25 to 74. The renewed cervical screening test looks for the Human Papillomavirus (HPV) known to cause the majority of cervical cancers.

As those aged 70-74 were not included in the previous screening model, awareness of the need to test and the availability of testing may be lower in this age group. Discomfort with the method of sample collection may also play a role in low participation rates, but changes have been made to make sample collection easier for patients.

Self-collect as a cervical screening option

In July 2022, self-collection of samples for cervical screening tests became available to all people with a cervix aged 25-74. This means patients will no longer need their doctor or nurse to insert a speculum to collect the cervical sample.

On behalf of Pathology Awareness Australia, Adjunct Professor Annabelle Farnsworth said: “The main thing to remember is that we still see cervical cancers occurring in those aged 45 and up who have no history of cancer screening. This group is also unvaccinated due to their age, and it breaks your heart when you know there is a screening program to prevent these cancers, but they haven’t accessed it for whatever reason.”

This week Adj. Prof Farnsworth encouraged GPs to offer self-collect to their patients and open the conversation with older women particularly.

Anyone who is unsure if they are due for a cervical screening test can ask their healthcare provider to check the National Cancer Screening Register to find out their status.

Adj. Prof Farnsworth added; “We also know that there are other groups who may have lower screening awareness such as people from culturally and linguistically diverse backgrounds, particularly those who came to Australia from countries without cancer screening programs. We also want to encourage awareness in the LGBTQI+ community, anyone who has a cervix should be screened. The beauty of self-collection is that anyone who was hesitant because they didn’t want the speculum examination can now take part in screening.”

Adj. Prof Farnsworth noted that the availability of self-collection was a good starting point for healthcare professionals to raise the topic of testing with under-screened people.

HPV & vaccination rates

Before the pandemic, Australia was leading in cervical cancer elimination due to prevention measures. A 2018 study in The Lancet noted that with a combination of screening and vaccination, Australia could be one of the first countries in the world to eliminate cervical cancer as a public health problem and could do so by 2035.³

However, most women in their 50s, 60s and 70s would not have been vaccinated against HPV, as the National HPV Vaccination Program in schools only began in 2007. Liz Ham, National Health Promotion Manager at Australian Cervical Cancer Foundation said:

“Although we do have great vaccine coverage in Australia due to the vaccination program in schools, there is a cohort of middle-aged and older Australians who missed out on vaccination and can therefore be vulnerable to HPV infection. Migration and travel also mean that some people in Australia are not vaccinated because of where they were born. The vaccine also doesn’t cover every strain of HPV so cervical screening continues to be an important part of cervical cancer prevention.”

Eliminating cervical cancer relies on participation in the HPV vaccination and screening programs in order to effectively diagnose and prevent cancers.

Jean Hailes for Women’s Health CEO Janet Michelmore AO said: “We are keen to remind women about health checks they may have missed due to lockdowns and the pandemic creating disruption in people’s lives. It may seem easy to put off check-ups when so much else is going on, especially if you feel well, but cancer doesn’t discriminate. Early diagnosis is beneficial for almost any health condition so please don’t put off vital screening tests.”

Delayed diagnosis of cervical cancer could lead to the need for more invasive treatment. In 2019, 179 women aged 25–74 died from cervical cancer.¹

Read more about how low participation in the national cervical screening program puts Australians at risk of avoidable cancers.

References:

1. National Cervical Screening Program monitoring report 2021, downloadable here: https://www.aihw.gov.au/reports/cancer-screening/national-cervical-screening-program-monitoring-rep/formats
2. https://www1.racgp.org.au/newsgp/clinical/drastic-drops-in-cancer-and-heart-attack-patients
3. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667%2818%2930183-X/fulltext

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According to the Cancer Council, about 15,500 Australians are diagnosed with bowel cancer every year, and although it is most common in people over 50, it can develop at any age. Bowel cancer claims the lives of 5,255 people a year.

Bowel cancer typically develops in the inner lining of the bowel and usually begins with growths called polyps, which may become cancerous if left undetected. While the risk of developing bowel cancer increases with age, if detected early there is a better chance of it being treated successfully.

Online publication, Starts at 60 sat down with the experts for an in-depth look at the symptoms, risk factors and what steps to take to prevent bowel cancer developing. Read the full article featuring Anatomical Pathologist and Ambassador for Pathology Awareness Australia, Dr Nick Musgrave

VIDEO: SBS Broadcaster Anton Enus learns about bowel cancer testing inside a pathology lab

The post Are you at risk of bowel cancer? Signs, symptoms and who should get tested first appeared on Know Pathology Know Healthcare.

The National Cervical Screening Program monitoring report 2021 from the Australian Institute of Health and Welfare (AIHW) shows that of those invited for a screening test during 2020, only 20 per cent completed the test within 12 months¹.

In the 25-29 age group, only 12 per cent of those invited to screen had their test.

The report estimates that overall only 62% of eligible people participated in the cervical screening program in 2018-2020.¹

VIDEO: Professor Marion Saville speaking to Channel 7 Sunrise

While it is unclear how much of an impact the pandemic has had on cervical screening uptake, routine healthcare participation was significantly affected, with pathology testing rates dropping by around 40 per cent² in the first months of COVID-19 restrictions.

Women aged 25-74 are recommended to have a cervical screening test every 5 years. The test looks for the Human Papillomavirus (HPV) known to cause the majority of cervical cancers.

In July 2022, self-collection of samples for cervical screening tests has become available to all people with a cervix aged 25-74. This means patients will no longer need their doctor or nurse to insert a speculum to collect the cervical sample.

On behalf of Pathology Awareness Australia, Professor Marion Saville AM said: “Australians need to be aware that prevention of cervical cancer requires regular screening as well as HPV vaccination for those who are eligible. Young people who have been vaccinated are not protected against every type of HPV so still need to be tested.”

Anyone who is unsure if they are due for a cervical screening test can ask their healthcare provider to check the National Cancer Screening Register to find out their status.

VIDEO: Prof Marion Saville speaking on 10 News

Prof Saville added; “HPV is a very common virus and most adults who are sexually active will be exposed to it during their lifetime. HPV can cause changes in the cells that lead to cancer. If this isn’t picked up early it can require more invasive treatment that can affect reproductive choices and of course in the worst cases, cervical cancer can be fatal.

From this month, people will be able to collect their own sample from the vagina using a small swab for their cervical screening test. We hope that this encourages more people to come forward for screening.”

The test is now only required every 5 years (for those testing negative to HPV) and is recommended for anyone with a cervix who is sexually active, aged between 25-74.

The National Cervical Screening Program changed to a 5 yearly cycle from a 2 yearly cycle in December 2017.

Before the pandemic, Australia was leading in cervical cancer elimination due to prevention measures. A 2018 study in The Lancet noted that with a combination of screening and vaccination, Australia could be one of the first countries in the world to eliminate cervical cancer as a public health problem and could do so by 2035.³

Liz Ham, National Health Promotion Manager at Australian Cervical Cancer Foundation said:

“Although we do have great vaccine coverage in Australia due to the vaccination program in schools, there is a cohort of middle-aged Australians who missed out on vaccination and can therefore be vulnerable to HPV infection. Migration and travel also mean that some people in Australia are not vaccinated because of where they were born. The vaccine also doesn’t cover every strain of HPV so cervical screening continues to be an important part of cervical cancer prevention.”

Eliminating cervical cancer relies on participation in the HPV vaccination and screening programs in order to effectively diagnose and prevent cancers.

A study published in Medical Journal Australia in 2019 noted the prevalence of cancer-causing HPV types other than type 16 and 18, was highest in women aged 25–29 years.⁴

Jean Hailes for Women’s Health CEO Janet Michelmore AO said: “We are keen to remind women about health checks they may have missed due to lockdowns and the pandemic creating disruption in people’s lives. It may seem easy to put off check-ups when so much else is going on, especially if you feel well, but cancer doesn’t discriminate. Early diagnosis is beneficial for almost any health condition so please don’t put off vital screening tests.”

Delayed diagnosis of cervical cancer could lead to the need for more invasive treatment. In 2019, 179 women aged 25–74 died from cervical cancer.⁵

References:

1. https://www.aihw.gov.au/getmedia/2a26ae22-2f84-4d75-a656-23c329e476bb/aihw-can-141.pdf.aspx?inline=true
2. https://www1.racgp.org.au/newsgp/clinical/drastic-drops-in-cancer-and-heart-attack-patients
3. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667%2818%2930183-X/fulltext
4. https://www.mja.com.au/journal/2019/211/3/routine-cervical-screening-primary-hpv-testing-early-findings-renewed-national
5. https://www.aihw.gov.au/reports/cancer-screening/national-cervical-screening-program-monitoring-rep/formats

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In most cases, Rapid Antigen Tests are being completed in home settings meaning responsibility is placed on the patient to ensure their positive infection is recorded and reflected in Australia’s healthcare data.

This is the first time that the public have been given this duty.

Before the pandemic, recording of specific communicable diseases was managed by healthcare professionals and pathology laboratories through the National Notifiable Diseases Surveillance System (NNDSS).

The system captures a long list of notifiable diseases including laboratory confirmed influenza, syphilis, hepatitis and measles, plus diseases rarely seen in Australia such as leprosy.

For these diseases health professional consultation and pathology test results confirm the diagnosis, which is then reported to the NNDSS, ensuring there is an accurate record and disease outbreaks can be tracked.

Pathologists are concerned that without a full picture of all COVID-19 infections in the community, recording both laboratory and RAT results, public health data will become inaccurate.

Pathology Awareness Australia ambassador Dr Caitlin Keighley is a microbiologist and infectious diseases physician. She is urging the public to report their positive COVID-19 tests, she said:

“Without accurate public health data on COVID-19 infections, we have no way of knowing what the true number of positive infections in the community. Reporting every positive Rapid Antigen Test is the only way we can count positives. This data is vital to planning public health responses and assessing the impact of treatments and vaccines for COVID-19.”

When a positive RAT is reported via phone or online to state health departments, every patient receives a survey to fill out, clarifying their ability to safely manage COVID-19 symptoms while isolating at home.
Patients filling out this survey provide the health department with information on the number of COVID-19 patients that can manage their symptoms effectively, as well as those who require assistance, and the number of people who are at high risk of more severe disease.

This is also important for patients to ensure they are provided information about accessing treatment for COVID-19, particularly those who are higher risk such as the immunocompromised and older Australians.

While Rapid Antigen Tests have assisted COVID-19 testing in terms of accessibility and convenience, there is some concern among pathologists around the accuracy of the test and the reporting of test results. PCR testing is still the most accurate test, therefore if there is uncertainty around RAT results, pathologists recommend getting a PCR test.

Tests performed in a home setting are more open to user error and the obligation to record positive results rests with patients, who may not be aware of this duty, or of reporting mechanisms.

Dr Keighley said, “I urge Australians to report all positive Rapid Antigen Tests to their state health department. When you are unwell, reporting your positive test may not seem like a priority, but it is so important to take the time to do so. It informs us of the public’s resistance to the virus and allows us to take steps to reduce its effect on patients.”

Accurate infectious disease data is critical for microbiologists and infectious disease experts, like Dr Keighley, in the long-term management of viral community outbreaks and new COVID-19 variants.

COVID-19 Polymerase Chain Reaction (PCR) tests performed in a pathology laboratory are still widely available and Australians can find local testing sites through their state health department or contact their healthcare provider about testing. All PCR results are then sent to state health departments by pathology laboratories.

In Australia, all positive COVID-19 test results are required to be reported.

Australia currently has the highest per capita rate of COVID infections of any comparable country in the world. High rates of infection allow high rates of mutation and the possibility of new variants emerging. Continued testing and accurate reporting will minimise transmission and in turn, COVID infections.

For those with concerns over language barriers, online forms to report a positive COVID-19 test result is compatible with most translation reader technology.

Read media coverage on this topic here:

SBS News

The New Daily

7News

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