70% of medical decisions rely on pathology. The service plays an invaluable role in the detection, diagnosis and treatment of disease. Whether it’s a routine health screen, cancer diagnosis, or blood donation— patients depend on pathology in every country across the globe.

Australia boasts 1,800 pathologists and 35,000 people working in pathology, including roles that range from medical scientists to lab technicians and collectors. These are the people responsible for processing 500 million samples each year.

With the highest global quality standards, rapid turnaround times and highly trained workers, Australian pathology is literally world class and should be recognised as such.

On International Pathology Day, events are being held around the world to explore the potential of pathology in addressing global health issues.

London will play host to ‘Pathology and Cancer’, a live webinar roundtable discussion on the critical role of pathology in meeting the commitments of the World Health Organisation’s (WHO) Cancer Resolution.

Organised by the British Royal College of Pathologists, this important roundtable will bring together an internationally-renowned panel of speakers to explore ways to ensure international cancer control plans adequately address the provision of effective and affordable pathology services.

In Malaysia, students and aspiring pathologists from University of Malaysia Sarawak, will host a celebration at the Museum of Anatomy and Pathology. The interactive event will feature scientifically themed games and food to teach students about the value of pathology.

Back in Australia, Tasmanian pathologists will be hosting a breakfast in Hobart to highlight the importance of bowel cancer screening as part of the #justpooit campaign. Attendees will include Parliamentary MPs, the Hobart Lord Mayor and the CEO of Cancer Council Tasmania. The event will bring together bowel cancer survivors and experts to discuss the effectiveness of bowel screening in preventing deaths through early detection.

Throughout the day, Tasmanians can learn about pathology at various pop-up stalls around the island. Information stalls will be located outside the Royal Hobart Hospital, Launceston General Hospital, North West Regional Hospital, Mersey Community Hospital, Launceston Pathology and Hobart Pathology.

In celebration of International Pathology Day, The Royal College of Pathologists of Australasia (RCPA) will be running a competition for anyone hosting their own event. The competition is open to all hospitals, collection centres, laboratories, medical schools/universities who have signed up to receive RCPA’s free promotional packs. To enter, you can post information and photos of your events directly to RCPA or to RCPA’s Facebook page.

No matter where you live, without pathology workers, there is no medicine. Today, we’d like to say a heartfelt thank you to the hidden heroes of healthcare.

The post Happy International Pathology Day! first appeared on Know Pathology Know Healthcare.

Newborn screening started in the USA in 1963 with a blood test for phenylketonuria (PKU) developed by Microbiologist Robert Guthrie.

Australia began screening for PKU in 1964, and screening for congenital hypothyroidism followed in the early 1970s. The testing used dry blood spots on filter paper cards developed by Guthrie.

Cystic Fibrosis (CF) was added as a screening test in Australia in 1981. Data showed that by screening for CF, a child’s time in hospital could be reduced from 1 month per year to just 3 – 4 days.

Despite this proven benefit, CF screening has only been taken up by the rest of world in the last ten years. Previously doctors could only diagnose a child once symptoms developed.

In 1997 Australia was the first country to start large-scale screening with tandem mass-spectrometry. This technique meant pathology labs could test for up to 30 disorders on one sample.

The ability to screen for more disorders has obvious benefits, but Associate Professor Veronica Wiley says there is a need for caution when adding new tests.

 “It’s all about finding disorders that can be treated. We have to ask the questions: do we want to know at birth? Sometimes a disorder won’t develop symptoms until adulthood so is there a benefit to knowing so early? And does screening improve the child’s life?”

The development of next generation sequencing has enhanced the ethical concerns around screening. We have more information than ever available to us but we must be careful in deciding what we do with it.

The development of new drugs to treat specific forms of genetic disorders such as CF or muscular dystrophy, alongside a new capability to screen for the gene mutations that cause the disorders, means more screening and effective, earlier treatment paths.

A/Prof Wiley hopes one day every baby, wherever they are born, will be given the healthiest start to life possible;

“We’re at the feel good end of the genetics market – children are performing better and we’re saving lives.”

The post “Kids are doing better and we’re saving lives”: how Australia has led the world in newborn screening first appeared on Know Pathology Know Healthcare.

Young women are becoming complacent when it comes to the Pap test.

New data has revealed an almost seven per cent drop in cervical cancer screening rates for women, aged 20 to 29 years old, across the state.

Ballarat father-of-two Lucas Ellis said a Pap test was a little bit of awkward for a lot of peace of mind. He has remained vocal about men playing a more encouraging role for the women in their lives, after losing his wife Melissa to cervical cancer in 2010.

Melissa was 34 years old.

“We were sitting down on the couch together about 12 months before her diagnosis when an ad came on television about it. I asked how long since she had been tested and her answer was abrupt…I wish I had pushed more,” Mr Ellis said. “I encourage women to get it done, even though it’s an uncomfortable procedure, and for men to be understanding and supportive about testing.

“Once upon a time, breast screening was a taboo topic but its all just part and parcel of getting testing done now.”

In Ballarat, only 56.8 per cent of women are getting regular Pap tests. This is compared to 57.1 per cent in 2006-07. Ballarat ranks in the bottom 30 per cent of local government areas with the lowest rates of women having regular tests, according to the Victorian Cervical Cytology Registry.

Proportion of women tested about the region has also dropped marginally in Golden Plains (62.7 percent regularly tested) and Hepburn (60.3), while screening rates in the Pyrenees Shire have slid from 56.9 per cent to 53.8 and among the lowest rates in the state.

National guidelines recommend all women aged 18 to 70 who have ever been sexually active should have a Pap test every two years – even if they have had a HPV vaccine, which may only protect against certain strains.

Most women with cervical cancer have not had regular Pap tests.

Early stages of cervical cancer often have no symptoms but can be preventable if caught early. Regular screening plays a key role in early detection.

Mr Ellis said his family had no idea. The week before Melissa’s diagnosis, they had been on a family holiday in Queensland.

All of a sudden, Melissa experienced heavy bleeding and was sent to a specialist in Melbourne. She died three months later.

The post Pap test: a little awkward for a lot of peace of mind first appeared on Know Pathology Know Healthcare.

She’d turned 40 just months earlier and was in a “good place” with her health, fitness and family. So when she noticed a hint of dull, “dusty pink” blood on her toilet paper one day — with no other symptoms — she didn’t think to act on it. Even when she eventually went to have it checked out, Deb was sure nothing was wrong, and her doctor was equally unconcerned.

“She said, ‘We’ll just do a stool test… you’re pretty fit and healthy and young so it’s probably nothing sinister, but we’ll just check it out anyway’,” the mum of two recalls.

This test detected a small amount of blood, so Deb was referred to a surgeon at her local hospital on the NSW south coast who put her on the waiting list for a colonoscopy. It was at this point she began to notice more blood.

“I started to worry, but I still didn’t feel sick. I still didn’t feel off. Like, my bowels were normal and I didn’t feel unwell in the slightest,” she recalls.

Deb ended up booking in at a private clinic in a nearby town to speed up the process. When she awoke from the colonoscopy, Deb was told her symptoms had most likely been caused by polyps, but that she would receive her test results the following week.

However, within days she was back in her GP’s office receiving some unthinkable news. “[My doctor] was very apologetic, very upset. She couldn’t even tell me… she’s just pushing this pathology result in front of me saying, ‘You read it’,” Deb, now 43, says.

Her own reaction was one of shock, and worry for the future of her daughters Kelsey, 20, and Stevie-Rae, 16.

“My first thought was how hard this is going to be for them. I felt like my life was over… To me it was a death sentence,” she recalls.

“You know when you watch a movie and they show when someone gets told they get cancer and everything around them goes hazy and muffled? That’s exactly what happened.”

Fortunately, after four surgeries and six gruelling months of chemotherapy, a scan revealed Deb was “all clear” and that her cancer hadn’t grown back. Three years on, she knows all too well the role her stool test, colonoscopy and regular blood tests played in her diagnosis and treatment.

Deb knows exactly how easy it is to be deterred from having screening tests in the first place. Some of them, like a faecal occult blood test, can be off-putting.

Pathology Awareness Australia (PAA) is currently on a mission to raise understanding of the importance of pathology; as its Chair John Crothers points out, 100 per cent of cancer diagnoses and 70 per cent of all clinical diagnoses are based on pathology services.

“The critical role of healthcare is early intervention, early diagnosis or even prevention overall. Pathology is central to that,” he explains.

Three years on from her cancer diagnosis, Deb is doing her own bit to increase awareness of the role of pathology in early diagnosis. She now works with the Jodi Lee Foundation, a leading bowel cancer awareness charity, using her experience to raise funds and spread an important message about screening.

“For me, it’s about teaching people in my own little community that you have to look after your bowel. I said this at a trivia night last year — ‘If I didn’t look at my toilet paper when I went to the toilet, I may not be here today’,” she says.

“People go, ‘Oh, I can’t look at that, that’s disgusting,’ and I get that it is, but it saved my life.”

This is an edited version of an article from The Glow 17th February 2016 – read the original source here: http://www.theglow.com.au/health/pathology-bulk-billing-incentive/

The post Why paying attention to her toilet movements saved Deb Weeks’ life first appeared on Know Pathology Know Healthcare.

Rapid advances in our understanding of genetics and the technologies required to analyse our genes have seen increased demand for genetic testing. Whilst some genetic testing is performed in research facilities, many tests are now offered clinically via pathology laboratories.

So what is genetic testing?

First we need to know the basics of what DNA and genes actually are.

DNA is like an instruction manual that tells our bodies how to grow, function and repair. It does this by making all the proteins that perform incredibly important but seemingly mundane tasks that we never think about – like building new heart muscle, or maintaining the microscopic scaffolding that makes up our eyes.

A gene is a small section of DNA that codes for a specific protein. Humans have many genes in common that are identical or very similar. Small differences in some genes are harmless – this is why we see blonde haired and dark haired people.  These minor changes drive evolution over many years.

However, some proteins perform functions that are necessary for life. Even the tiniest change in the gene’s coding for these proteins can have disastrous consequences.

Genetic changes are generally caused by changes in the way DNA is copied as a cell divides. If a serious change is present in an egg or sperm at the point when a baby is conceived, it will cause a genetic condition. Cystic Fibrosis and Muscular Dystrophy are examples where essential genes are changed, resulting in malformed proteins that can’t perform vital functions.

Sometimes mistakes in DNA accumulate over time as we age. These can cause cancers. Some changes to DNA don’t directly cause cancer, but can put someone at higher risk of developing cancer for example the genes BRCA1 and 2.

Genetic testing is now used in a wide range of ways, but the most common uses include:

• Newborn screening for genetic conditions such as Cystic Fibrosis
• Genetic testing to diagnose a genetic disorder such as haemochromatosis
• Non-invasive prenatal testing for Down Syndrome

What samples can be tested?

The most commonly used sample is blood, but DNA can also be extracted from

• saliva
• a biopsy of the tissue you want to examine – such as a tumour biopsy, bone marrow biopsy, or a placental biopsy
• skin cells – hence the cheek swabs used in crime dramas
• hair, and even urine and faeces

What other ways is genetic testing used?

Genetic testing has a number of other uses including:

• helping doctors choose the most effective cancer treatment
• checking organ donor and recipient compatibility
• infectious disease testing – this type of testing is different to those above because rather than examining the patient’s DNA it looks for the DNA of the actual bacteria or virus
• identity testing for criminal investigations (commonly referred to as DNA testing)
• parentage testing

Pathology can discover an enormous amount about a person’s genetic make up – the Catalogue of Genetic Tests and Laboratories contains over a thousand tests. As well as providing information about the individual patient, the results of these tests can help doctors find genetic information that could affect other family members, who may then also have genetic tests performed. Early detection of genetic risk factors can provide a chance for monitoring and preventative measures.

The post ‘In-gene-ious’ – the future of pathology is in our DNA first appeared on Know Pathology Know Healthcare.