In response to the Royal College of Pathologists (RCPath) submission to the Government’s Men's Health Strategy for England, we connected with Martin Goddard, RCPath’s subspecialty adviser on Cardiac Pathology, to discuss the investment gaps in pathology services for men’s health.
What motivated the RCPath to respond to the government’s Men’s Health Strategy call for evidence?
Pathologists contribute to the care of all patients through laboratory services and have a unique perspective on the incidence, prevalence, and evolving patterns of disease within communities. This positions them to provide valuable evidence to support and inform government health initiatives. In addition, autopsy pathologists play a critical role in identifying changing disease trends as they relate to causes of death, particularly in cases that are sudden or unexpected.
How do you envision pathology services, particularly diagnostics, playing a more central role in the delivery of the Men’s Health Strategy?
Pathology testing enables high-volume, cost-efficient population screening, facilitating early disease detection that prompts timely investigation and treatment. Earlier intervention improves outcomes, and in the era of molecular pathology, testing also supports more personalized, patient-directed therapies.
What are some of the biggest risks to men's health in the UK, and how can pathology testing help mitigate the risks?
Hypertension is often a silent disease but can cause significant damage to the heart and other organs if left untreated. Monitoring relies on regular blood pressure measurement, which lies outside the scope of pathology services. The challenge is encouraging routine checks to prevent long-term complications.
Diabetes, on the other hand, can be detected through blood or urine glucose testing. Long-term outcomes depend on early detection and effective control, which can be monitored using HbA1c. Regular testing is essential to optimize management and improve disease control.
How can autopsy pathology findings inform upstream public health policy or screening program design?
In sudden death cases, pathologists often observe hearts that are enlarged, heavy, and dilated in the absence of underlying valvular disease. This is frequently the result of unrecognized hypertension, with little or no documentation of blood pressure measurements in primary care records.
Additionally, many patients with diagnosed diabetes mellitus present with elevated HbA1c levels, reflecting suboptimal disease control.
How can the pathology profession help normalize conversations around routine testing and early intervention for men?
It is important to highlight the risks of not engaging with health screening, as well as the long-term benefits that simple interventions and treatments can provide. While data are available on excess deaths related to road pollution, comparable data on the impact of undiagnosed hypertension in the general population remain lacking.
What are the key considerations for expanding direct-access diagnostic services in community settings?
Improving access to testing through point-of-care (POC) methods could increase uptake, but this must be supported by a robust system that ensures individuals can access appropriate healthcare for any issues identified. Social media can play an important role in prompting people to undergo these simple tests. Laboratories, in turn, must support point-of-care testing through quality control initiatives and ensure appropriate follow-up of abnormal results.
What specific policy recommendations has the RCPath made to ensure pathologists and laboratory scientists are integrated into the national implementation of the strategy?
Early diagnosis depends on robust diagnostic services, with scientists and clinicians guiding the appropriateness of testing and monitoring strategies.
Technological advances have driven the rapid development of POC testing options for use in community settings and even in patients’ homes. Implemented effectively, POC testing could improve efficiency and help establish true "one-stop diagnostic shops."
However, barriers such as limited funding, insufficient staffing, and poor IT connectivity pose risks of unsafe and inappropriate services. In addition, the lack of governance, accreditation, and alignment with professional body guidance remains a major concern.
Without regulation to ensure quality, accuracy, and clinical utility – and without proper staff training and adherence to best-practice guidelines – POC testing cannot be delivered safely or appropriately.
How would you summarize the most urgent changes needed within diagnostic medicine to meaningfully improve cardiovascular outcomes for men over the next 5-10 years?
Better outcomes depend on early diagnosis, effective monitoring, and timely intervention. The key challenge is detecting "silent" disease before irreversible damage occurs.
Newsletters
Receive the latest pathologist news, personalities, education, and career development – weekly to your inbox.
