Ovarian cancer and Medicare funded testing in Australia
The revised Medicare criteria means that funded testing is now available for a wider range of ovarian cancers and that age at diagnosis is no longer a barrier.Medicare funded (bulk billed) genetic testing, under item 73296 is now available for:
- all women, regardless of their age at diagnosis or current age
- diagnosed with ovarian cancer that was high grade epithelial, non mucinous
- this includes endometrioid, clear cell and serous kinds of ovarian cancer
This is an important change. It means that women don't have to wait until their ovarian cancer recurs to get a funded genetic test.
Testing under item 73296 looks for inherited (germline) mutations in genes that are associated with a moderate or high risk of breast and/or ovarian cancer.
Testing includes a panel (group) of genes that are associated with
- an increased risk of ovarian cancer risk (such as BRIP1)
- both ovarian and colon cancer risk (such as BRIP1, BRCA1, BRCA2, PALB2, RAD51C, RAD51D and STK11)
- ovarian, colon (bowel) and uterine cancer risk (the Lynch syndrome genes MLH1, MSH2, MSH6 and PMS2)
- breast cancer risk (such as ATM, BARD1 and CHEK2)
To be bulk billed, the test must be ordered by a specialist, such as a Genetic Oncologist , or consultant physician, not a GP or genetic counsellor
As Medicare will only pay once under this item number, a full panel should be chosen (eg a panel including Lynch syndrome as well as breast and ovarian cancer risk genes, not just BRCA1 and BRCA2).
If no germline mutation is detected, somatic (tumour) testing may still be performed if PARP inhibitor treatment is being considered. This testing would still be Medicare funded under items 73301 and/or item 73307 and is usually ordered by the Medical Oncologist.
Item 73307 provides the lab with almost $3,000. As a result, some labs offer a much more detailed test at no extra cost, such as a TruSight 500 panel, to look for other weaknesses in the cancer. Note:Medicare will only pay for this kind of tumour testing once.