Ampath Laboratories DxINSIGHTS - Issue 8 - August 2024

Introduction

The do's and don'ts of laboratory screening in general practice for patients over the age of 40

Screening is the process of testing a group of apparently healthy individuals to identify undiagnosed disease as early as possible before symptoms develop. This may be done in those at higher risk of disease to offer treatment or other interventions.

Primary and secondary prevention strategies in the fight against cervical cancer

Cervical cancer was identified as a national priority in South Africa in 2017. More than 10 000 new cases of cervical cancer are diagnosed in South Africa each year. It was the leading cause of female cancer deaths in the15−44 year-old age group with a mortality rate of 19.6 per 100 000 women in 2020.2 The age-standardised incidence rate in 2020 in South Africa was estimated to be 35.3 per 100 000 women, which is almost three times the global average of 13.3 per 100 000 women.2 The World Health Organization (WHO) announced its global strategy to eliminate cervical cancer as a public health problem in May 2018. The aim of the strategy is to achieve a cervical cancer incidence rate of below 4 per 100 000 women per year. It set three main objectives to achieve this outcome:

• To vaccinate 90% of girls by 15 years of age with an effective HPV vaccine. 

• To screen women for cervical cancer with a high-performance test by 35 years of age and again at 45 years of age. 

• To treat 90% of women with pre-cancerous lesions or invasive cancer.

HIV pre-exposure prophylaxis (PEP)

The estimated number of people living with human immunodeficiency virus (HIV) in South Africa by 2022, was 7.6 million, of which 160 000 were new infections. About 75% of those infected were on antiretroviral (ARV) treatment, with 69% of those on treatment being virally suppressed. Preventative strategies against new HIV infections include the use of pre-exposure prophylaxis (PrEP), which entails the use of ARV drugs by individuals who are HIV negative to prevent HIV infection. PrEP reduces the risk of getting HIV from sex by about 99% and from injection drug use by at least 74%. Persons who were recorded to have received HIV PrEP at least once by 2022 were estimated at 406 170. There is a need to educate young people and those at high risk of HIV infection in South Africa about HIV PrEP and its benefits.

Multiple Myeloma: The benefits of screening

Multiple myeloma (MM) is a bone marrow cancer characterised by the neoplastic proliferation of plasma cells, with a resultant increased production of abnormal immunoglobulins (Igs) and subsequent organ damage, collectively known as CRAB features (hypercalcaemia, renal failure, anaemia and bone lesions).