Early Detection Australia

Diagnostic options

There's more than one way to look for cancer

From diagnostic tests spanning pathology through to medical imaging (radiology), doctors use a variety of tools to assess for signs and signals of cancer. Each one has its unique strengths, suits different situations and comes with differing costs. Here is a guide to the options available in Australia.

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More than one way to look for cancer: medical imaging (radiology), blood tests, and biopsy and cytology.

The basics

Screening and diagnostic tests are not the same thing

It helps to know which kind of test you're talking about, because it affects who it's for, how you access it, and what you pay.

Screening tests

For people with no symptoms
Screening looks for early signs of cancer in people who feel well. Australia has four national screening programs (breast, bowel, cervical and lung), and they're free or covered by Medicare for eligible people.7,8,9

Diagnostic tests

For diagnosis, or a higher personal risk
Diagnostic tests are arranged by a doctor to investigate symptoms or a specific concern. These tests can help identify cancer, and in some cases multiple cancers. You'll need a doctor's request, and costs vary.5

Know your options

The main ways doctors look for cancer

Most diagnostic tests fall into two groups: medical imaging (radiology), which creates pictures of the inside of the body, and pathology, which tests samples from your body, in a laboratory. Your doctor chooses tests based on your symptoms, your history and the type of cancer under investigation.1 There is no single standalone test for cancer. Tests are often more informative when used together to help guide care.1

Medical imaging (radiology)

Imaging scans that create pictures of the inside of the body

  • Ultrasound
  • X-ray
  • Mammography
  • Fluoroscopy
  • CT
  • MRI
  • PET
How it works
Each scan uses a different technology: sound waves (ultrasound), X-rays (X-ray, mammography, fluoroscopy and CT), magnetic fields and radio waves (MRI), or a small amount of radioactive tracer (PET).2,3
Often used for
A first look at areas like the liver, pelvis and breast, then detailed views to find a tumour, show its size and whether it has spread, and plan treatment.1,4 Mammography is used in BreastScreen Australia, and a low-dose CT in the National Lung Cancer Screening Program.8,9
Good to know
Ultrasound and MRI don't use ionising radiation. X-ray, mammography, fluoroscopy, CT and PET involve a dose of radiation. MRI may not suit people with some implants or devices, and takes longer.2,3

General cost

Most scans are Medicare rebated with a valid doctor request. Many clinics bulk bill; others charge a gap. MRI and PET are only rebated for specific Medicare-listed scans, and some need a request from a specialist, so they're often the most expensive.6

Pathology

Samples of blood, tissue, cells or fluid tested in a lab

  • Blood tests
  • Tissue biopsy
  • Fine needle aspiration
  • Body fluid analysis
  • Swabs & exfoliative sampling
  • Brushings, washings & lavage
How it works
A sample is collected and sent to a pathology lab, where it's tested or examined under a microscope.11 Blood tests can check your general health as well as test for certain cancers. A biopsy removes a small piece of tissue or some cells.11 Cellular review (cytology) looks at cells collected by a fine needle, swabs, exfoliative sampling, brushings, washings, lavage or from a body fluid.
Often used for
Direct sampling of an area under investigation and for identifying cancer if present.11
Good to know
A blood test result on its own doesn't always confirm cancer, so your doctor will usually arrange follow-up tests to confirm what it means.4 A biopsy is usually done under local anaesthetic, and may be guided by ultrasound, X-ray or CT.11

General cost

Medicare covers most pathology tests, however some specialised and genetic tests aren't covered.5 A biopsy may also involve procedure or specialist fees.

At a glance

How the options compare

Pathology

Test

Blood tests

Radiation exposure

No

Doctor request needed

Yes

Medicare

Depending on the test

Typical out-of-pocket

Moderate if not covered by Medicare

Test

Biopsy & cytology

Radiation exposure

No (unless imaging-guided)

Doctor request needed

Yes

Medicare

Most lab tests covered

Typical out-of-pocket

Nil to moderate, plus any procedure fees

Medical imaging (radiology)

Test

Ultrasound

Radiation exposure

No

Doctor request needed

Yes

Medicare

Rebate available

Typical out-of-pocket

Often low or nil if bulk billed

Test

X-ray, mammography & fluoroscopy

Radiation exposure

Yes

Doctor request needed

Yes (not for BreastScreen)

Medicare

Rebate available

Typical out-of-pocket

Often low or nil if bulk billed

Test

CT scan

Radiation exposure

Yes

Doctor request needed

Yes

Medicare

Rebate available

Typical out-of-pocket

Nil to moderate, depending on clinic

Test

MRI scan

Radiation exposure

No

Doctor request needed

Yes (some need a specialist request)

Medicare

Only for eligible scans and clinics

Typical out-of-pocket

Moderate to high if not eligible

Test

PET scan

Radiation exposure

Yes

Doctor request needed

Yes

Medicare

Only for eligible scans

Typical out-of-pocket

Moderate to high if not eligible

Sources: InsideRadiology; NPS MedicineWise; Department of Health, Disability and Ageing; healthdirect.2,3,5,6,11 Always ask the provider about fees before your test.

Costs

What do tests generally cost?

The Australian Government sets Medicare rebates, but each imaging or pathology provider sets its own fees.6 So the same test can cost different amounts at different clinics.

Bulk billed

$0 out of pocket
If the provider bulk bills, Medicare pays the full fee and you pay nothing. This is common for pathology and available for many scans.5,6

Gap fee

You pay the difference
If the fee is higher than the rebate, you pay the gap. Some clinics ask for the full fee upfront, then you claim the rebate.6

Not covered

Full private cost
Some tests have no Medicare rebate, such as some genetic tests or MRI scans that don't meet Medicare rules.5,6

Why it matters

The benefits of knowing your options

  • The right test for you
    Different tests suit different parts of the body and different situations. Knowing the options helps you have a more informed conversation with your doctor.1
  • A more complete picture
    Tests often work together. Pathology and medical imaging (radiology) each add information that a single test can't provide on its own.1,4
  • Choices without radiation
    Ultrasound and MRI don't use ionising radiation, which your doctor may weigh up when choosing a test.3
  • Earlier answers
    Early detection can improve outcomes for many cancers.10 Acting on symptoms or a known risk helps get answers sooner.

Take the next step

Not sure which test is right for you?

You don't need to decide on your own. A doctor can look at your symptoms, family history and personal risk, and advise which tests, if any, are appropriate.

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References

  1. 1.Cancer Council Australia. Tests and scans. cancer.org.au/cancer-information/tests-and-scans
  2. 2.Royal Australian and New Zealand College of Radiologists. InsideRadiology: Ultrasound, X-ray, Mammography, Fluoroscopy, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET). insideradiology.com.au
  3. 3.NPS MedicineWise / Australian Commission on Safety and Quality in Health Care. Your medical imaging test (patient resource). nps.org.au
  4. 4.Cancer Council Victoria. Primary liver cancer: diagnosis (blood tests and imaging scans). cancervic.org.au
  5. 5.healthdirect Australia. Paying for diagnostic testing. healthdirect.gov.au/paying-for-diagnostic-testing
  6. 6.Australian Government Department of Health, Disability and Ageing. What we're doing about diagnostic imaging (Medicare subsidies, provider fees, Medicare-eligible MRI units). health.gov.au
  7. 7.Services Australia. Screening, tests and scans covered by Medicare. servicesaustralia.gov.au
  8. 8.Australian Government Department of Health, Disability and Ageing. Cancer: cancer screening programs (BreastScreen Australia, National Cervical Screening Program). health.gov.au/topics/cancer
  9. 9.Australian Government Department of Health, Disability and Ageing. National Lung Cancer Screening Program. health.gov.au/nlcsp
  10. 10.Cancer Council WA. Screening and early diagnosis. cancerwa.asn.au
  11. 11.healthdirect Australia. Biopsy. healthdirect.gov.au/biopsy

Understand your risk. Know your options.

Explore the risk factors for different cancers, then talk it through with a doctor.

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