Plasma Uracil for DPD Deficiency Screening

PathWest is proud to introduce Plasma Uracil Testing

Plasma Uracil Testing

• Patients with dihydropyrimidine dehydrogenase (DPD) deficiency have a reduced ability to metabolise FP drugs and are at increased risk of early, severe, and potentially life-threatening toxicity.
• The risk of acute toxicity with FP therapy increases with the increasing uracil concentrations, associated with increasing risk of DPD deficiency.   

Important to note:

Eligibility

All patients scheduled to commence FP chemotherapy.

• Testing should be done prior to treatment initiation.
• Testing is only required once per patient.
• If the opportunity to test prior to initiation is missed, please contact the department for advice.

Ordering Process

• Restricted to Medical Oncology teams.
• Not available via CPOE.
• A specific request form must be used:
  • Hard copies have been distributed to Medical Oncology departments.
  • An electronic version is available here for printing and filling out.

• Requesting clinicians must:
  • Complete all tick boxes in the Clinical Notes section.
  • Clearly record both the Medical Oncology consultant’s name and the requesting doctor’s name (abnormal results will be phoned directly to the consultant).

Rollout and Collection

• Commencement Date: 1 September 2025
• Collection Sites:
  • PathWest Fiona Stanley Hospital (FSH)
  • PathWest Sir Charles Gairdner Hospital (SCGH), E Block
  • Monday to Friday, before 3:00 PM
• Private pathology collections are not accepted due to strict sample handling requirements.

Sample Handling

• Strict pre-analytical protocols apply.
• Delays in centrifugation or freezing may result in falsely elevated uracil levels.
• All results will be reviewed by a Pathologist prior to reporting and Uracil results will not be reported in cases of suboptimal pre-analytical sample handling. In these instances, the requesting doctor will be notified directly to arrange contacting patient for urgent re-collection of plasma uracil, and completion of a new pathology request form.

Turnaround time
7 days 

Cost to patient
No out-of-pocket cost to patients.