10-Year Trends in Lipoprotein(a) Testing in Queensland and Australia: A Retrospective Analysis of Ordering Patterns

Lipoprotein(a) [Lp(a)] is a genetically determined, highly atherogenic lipoprotein that contributes to cardiovascular disease and calcific aortic valve stenosis. Increased Lp(a) levels warrant intensified management of cardiovascular risk factors. With targeted Lp(a)-lowering therapies in clinical development, identification of individuals with increased levels has increasing therapeutic implications. Guidelines differ, recommending testing in either high-risk groups or universally once in a lifetime, yet testing rates remain low.

We performed a retrospective analysis of laboratory data from a large tertiary referral centre in Queensland, Australia, evaluating trends in Lp(a) testing between 1 January 2015 and 31 December 2024.

Lp(a) testing increased markedly over the 10-year study period. In Queensland, annual test volumes rose from 652 in 2015 to 4,364 in 2024. Including interstate referrals, test numbers increased from 2,686 in 2015 to 23,135 in 2024. The steepest rise occurred in the final 2 years of observation. Despite these increases, testing rates relative to the screened population remained low, and testing generally occurred late in individuals in their 50s.

Lp(a) testing has grown substantially in Queensland and Australia over the past decade, likely reflecting increased recognition of its causal role in cardiovascular disease, evolving guideline recommendations, test accessibility, and the emergence of novel therapies. However, overall testing remains limited. Broader implementation of guideline-based testing and greater clinician awareness will be critical to ensure timely identification of individuals who may benefit from available and emerging therapeutic strategies.