October 2025

Discoveries, trends, and discussions in medical diagnostics

Welcome to the October issue of Diagnostics Dialogue, where you can get up to speed on the most important discoveries, trends, and discussions in medical diagnostics. Continue reading to learn more.

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Better outcomes

Better outcomes

Beyond BRCA: Guideline-based genetic testing

1 in 8 women in the US will develop breast cancer in their life,1 and 5%-10% of breast cancer is hereditary.2
October is Breast Cancer Awareness Month—a good time to reinforce the value of screening and monitoring. | Learn more about our breast cancer portfolio >
Primary care providers are in the ideal position to offer early screening to help identify risk. Red flags to help identify high-risk patients include personal and family history of:
  • Breast cancer diagnosed < 50 years of age
  • Triple negative breast cancer
  • Two primary breast cancers (including bilateral)
  • Male breast, ovarian, pancreatic, or prostate cancer
  • Multiple family members or generations affected
Genetic testing has evolved beyond BRCA
  • Guidelines3-6 recommend genetic testing for multiple genes associated with hereditary breast cancer risk to avoid missing actionable genetic risk factors
  • The Quest Diagnostics Hereditary Breast Cancer Panel checks for variants in the BRCA1 and BRCA2 genes, along with 16 other genes (18 total) linked to inherited breast cancer risk
  • For individuals with a complex family history of cancer beyond breast cancer, a larger gene panel may be more appropriate
In addition to the Hereditary Breast Cancer Panel, Quest offers a Comprehensive Hereditary Cancer Panel (66 genes), and a Guideline-Based Hereditary Cancer Panel (32 genes).
Learn more about our comprehensive menu of hereditary cancer testing, or call us at +1.866.GENE.INFO (866.436.3463).

Streamline respiratory testing

Heading into the respiratory season, CDC data show influenza and RSV remain low, but COVID-19 is rising in many regions—a reminder of the shifting viral landscape as winter approaches.7
Because COVID-19, influenza, and RSV share symptoms such as fever, cough, and shortness of breath, clinical presentation alone often isn’t enough to identify the cause. For high-risk patients or anyone with acute respiratory illness, early, accurate detection helps guide timely treatment and avoid unnecessary antibiotics or delays.
A single molecular test, swabbed in your office, can detect COVID-19, influenza, and RSV to help streamline care and reduce repeat visits.
Quest Diagnostics offers a comprehensive menu of respiratory molecular combination tests with rapid turnaround, enabling providers to pinpoint infection quickly and tailor management before complications develop.

Updated ACG guidelines for H pylori testing

Helicobacter pylori (H pylori)—a common trigger of gastrointestinal disease and leading cause of infection-associated cancer worldwide8—affects about 1 in 3 people in the US.9

Testing for H pylori antibiotic sensitivity profiles has seen recent advances and implementation into clinical practice, and the 2024 American College of Gastroenterology guidelines have introduced significant updates to treatment and testing protocols.
The latest guideline highlights key actions for clinicians8:

Test and treat adults with dyspepsia under 60 (under 50 in higher-risk groups), patients with a history of peptic ulcer, unexplained iron-deficiency anemia, idiopathic thrombocytopenic purpura, chronic NSAID/aspirin use, or gastric premalignant lesions, plus household contacts and individuals with family or regional gastric-cancer risk

Confirm eradication in all treated patients using a urea breath or stool antigen test ≥4 weeks post-therapy and ≥2 weeks off PPIs

Choose therapy wisely: Since clarithromycin- and levofloxacin-resistance exceed 20%–30%, the guideline recommends 14-day bismuth quadruple therapy when susceptibility is unknown and supports molecular testing to guide tailored regimens

Better experiences

Better experiences

Explore HSV testing options

Herpes simplex virus (HSV), including both HSV-1 (oral) and HSV-2 (genital), affects millions of Americans—yet remains under-recognized. According to the American Sexual Health Association10:
  • Over 50% of US adults have oral herpes (cold sores), mostly from HSV-1
  • About 12% of people ages 14-49 have genital HSV-2 infection; up to 90% of those infected don’t realize it
Primary care is the place for important discussions

Ask about symptoms such as recurrent sores or mild discomfort that patients may dismiss

Consider HSV serologic or PCR-based testing when suspicion is higher (eg, partner has known infection, recurrent symptoms)

Counseling matters: Even without symptoms, transmission risk exists, so prevention and partner communication are important
Quest Diagnostics offers HSV testing that includes antibody and PCR / viral detection methods—helping clinicians with more precise diagnosis and management.

Get actionable cardiometabolic insights

Nearly half of Americans have a chronic disease; more than half of older adults have 3 or more chronic conditions.11 Medical societies such as the American Heart Association®, American Association of Clinical Endocrinology®, and the National Kidney Foundation® recognize the interrelated impacts of cardiometabolic conditions as well as the importance of prevention, early identification, and management of these conditions.
With just 1 panel and enhanced report, Quest Diagnostics makes it easier to identify and monitor cardiometabolic disease.
The Cardiometabolic Disease Assessment (CMDA) Panel with enhanced report provides a comprehensive and streamlined overview of cardiometabolic disease. Seven guideline-recommended and specialty tests are combined in a single panel with one test code and a consolidated, enhanced report. Together, they deliver detailed results that empower treatment strategies to help prevent, reverse, or slow the progression of multiple cardiometabolic diseases.

Removing traditional barriers to testing 

Removing traditional barriers to testing 

Removing traditional barriers to testing 

Listen to the hepatitis and HIV screening podcast

October is Liver Awareness Month—an ideal time to highlight how broader liver health connects to conditions like viral hepatitis.
MASLD is one of the fastest growing diseases in the US | 1 in 3 US adults are affected,12 yet < 1% are diagnosed13
Risk for advanced fibrosis rises sharply when MASLD and viral hepatitis overlap,14 and an estimated 19 million adults already have clinically significant liver fibrosis.15
Graphic chart demonstrating that risk for advanced fibrosis increases significantly with both MASLD and viral hepatitis
Shared progression calls for universal screening
The CDC recommends universal hepatitis B and hepatitis C screening for all adults.16-18 Earlier detection means earlier intervention—and a better chance to prevent irreversible damage.
Expert insight in our podcast
In a recent Results Are In episode, Dr Megan Starolis, Senior Science Director of Infectious Disease at Quest Diagnostics, explains the current hepatitis and HIV screening guidelines and how to put them into practice, including the following:
  • How coinfections accelerate disease progression
  • What’s new in screening panels and reporting from Quest
  • Ways Quest is making guideline-based screening easier for providers and patients
Listen to the podcast
Visit QuestIDScreening.com to see how we can help make universal screening part of every patient’s care.

See what’s next in testing for novel psychoactive substances

See what’s next in testing for novel psychoactive substances

See what’s next in testing for novel psychoactive substances

See what’s next in testing for novel psychoactive substances 

Quest Diagnostics will launch an enhanced novel psychoactive substances (NPS) Gen III panel later this year as part of our commitment to addressing the evolving challenges of illicit substances and prescription drug misuse.

Stay tuned for more details on the Q4 release and how this update will help clinicians stay ahead of an ever-shifting drug landscape.

As a reminder, you can listen to our podcast for insights into the evolving drug landscape.

Achieving the Quadruple Aim in your practice

Our purpose is to support you and your patients with leading services, improved patient experiences, and innovative testing that can help you provide clarity to the constant changes and challenges we’re seeing in healthcare today.

About Diagnostics Dialogue

In our conversations with providers across the country, we hear that you are facing many different constraints that make delivering care challenging. We’re here to help you navigate the uncertainty and deliver better health. With a broad test menu spanning 3,500+ tests and consultations from our medical staff of over 850 MDs and PhDs, we empower healthcare providers to create healthier communities, one patient at a time.
References
  1. Breastcancer.org. Breast cancer facts and statistics. Accessed September 18, 2025. https://www.breastcancer.org/facts-statistics
  2. CDC. What causes hereditary breast and ovarian cancers. August 28, 2024. Accessed September 24, 2025. https://www.cdc.gov/breast-ovarian-cancer-hereditary/causes/index.html
  3. National Comprehensive Cancer Network. NCCN clinical practice guidelines inoncology (NCCN Guidelines®): Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, and Prostate. Version 1.2026. July 10, 2025. Accessed September 25, 2025. https://www.nccn.org/guidelines/guidelines-detail?category=2&id=1545
  4. Ricker C, Arun B, Pirzadeh-Miller S, et al. Selection of germline genetic testing panels in patients with cancer: ASCO guideline clinical insights. JCO Oncol Pract. 2024;20(12):1308-1313. doi.org/10.1200/OP.24.00278
  5. American College of Obstetricians and Gynecologists. Hereditary cancer syndromes and risk assessment. ACOG Committee Opinion No. 793. Obstet Gynecol. 2019;134(6):e143-e149. Accessed September 25, 2025. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/12/hereditary-cancer-syndromes-and-risk-assessment
  6. American College of Obstetricians and Gynecologists. Cascade testing: testing women for known hereditary genetic mutations associated with cancer. ACOG Committee Opinion No. 727. Obstet Gynecol. 2018;131(1):e31-e34. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/01/cascade-testing-testing-women-for-known-hereditary-genetic-mutations-associated-with-cancer
  7. Chey WD, Howden CW, Moss SF, et al. American College of Gastroenterology. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2024;119(9):1730-1753. doi:10.14309/ajg.0000000000002968
  8. Aldhaleei W, Wallace M, Harris D, et al. Helicobacter pylori: a concise review of the latest treatments against an old foe. Cleve Clin J Med. 2024:91(8):481-487. doi:10.3949/ccjm.91a.24031
  9. American Sexual Health Association. Herpes: fast facts. Updated July 31, 2025. Accessed September 18, 2025. https://www.ashasexualhealth.org/herpes/
  10. Raghupathi W, Raghupathi V. An empirical study of chronic diseases in the United States: a visual analytics approach. Int J Environ Res Public Health. 2018;15(3):431. doi:10.3390/ijerph15030431
  11. CDC. Current epidemic trends (based on Rt) for states. Updated August 5, 2025. Accessed August 9, 2025. https://www.cdc.gov/cfa-modeling-and-forecasting/rt-estimates/index.html
  12. Harrison SA, Gawrieh S, Roberts K, et al. Prospective evaluation of the prevalence of non-alcoholic fatty liver disease and steatohepatitis in a large middle-aged US cohort. J Hepatol. 2021;75(2):284-291. doi:10.1016/j.jhep.2021.02.034
  13. Kaiser Permanente. Many adults may be unaware that they have liver disease. January 31, 2025. Accessed September 18, 2025. https://divisionofresearch.kaiserpermanente.org/unaware-masld-liver-disease/
  14. Digestive Disease Week. Viral hepatitis with concurrent metabolic dysfunction-associated steatotic liver disease is a subgroup at high risk for advanced fibrosis. May 21, 2024. Accessed September 18, 2025. https://ddw.digitellinc.com/p/s/viral-hepatitis-with-concurrent-metabolic-dysfunction-associated-steatotic-liver-disease-is-a-subgroup-at-high-risk-for-advanced-fibrosis-6469
  15. Kim HY, Yoon JW, An JY, et al. Prevalence of clinically significant liver fibrosis in the general population. Clin Mol Hepatol. 2024;30(Suppl):S205-S216. doi:10.3350/cmh.2024.0351
  16. Connors EE, Panagiotakopoulos L, Hofmeister MG, et al. Screening and testing for hepatitis B virus infection: CDC recommendations—United States, 2023. MMWR Recomm Rep. 2023;72(RR 1):1–25. Accessed June 26, 2025. https://www.cdc.gov/mmwr/volumes/72/rr/rr7201a1.htm
  17. CDC. Clinical screening and diagnosis for hepatitis C. January 31, 2025. Accessed June 26, 2025. https://www.cdc.gov/hepatitis-c/hcp/diagnosis-testing/index.html
  18. CDC. Getting tested for HIV. CDC.gov. February 11, 2025. Accessed June 26, 2025. https://www.cdc.gov/hiv/testing/index.html
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