Plasma Uracil for DPD Deficiency Screening

Plasma Uracil for DPD Deficiency Screening

PathWest is proud to introduce Plasma Uracil Testing

Plasma Uracil Testing

This test is designed to assist in identify, prior to initiation of therapy, patients who are at increased risk of early, severe toxicity from fluoropyrimidine (FP) chemotherapy, such as 5-Fluorouracil and capecitabine.

• 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. 

Contact Information
Sample collection, handling, or transport queries: Ms Conchita Boyder Scientist in charge, Special Chemistry, PathWest Laboratory Medicine WA 📞(08) 6383 4113	For queries regarding Plasma Uracil test interpretation: Dr. Rhonda Maguire Chemical Pathologist, Biochemistry,Clinical Pharmacology and Toxicology PathWest Laboratory Medicine WA 📧:Rhonda.Maguire@health.wa.gov.au