The Royal College of Pathologists of Australasia is calling for government action on chronic traumatic encephalopathy (CTE) to facilitate improved diagnosis, research and preventative policies.

In a new position statement published this month [link here], the RCPA said there was clear evidence of the casual link between exposure to repeated traumatic brain injuries and the development of CTE.

The RCPA has published five action points:

• The development of CTE prevention/risk minimisation protocols for all contact and combat sports. The RCPA recommends that low or no contact versions of sports are played by those under the age of 14.

• All health and medical services including state and territory forensic services to identify pathways for autopsy brain examination and/or donation for deaths where the family raise concerns over CTE.

• The inclusion of traumatic brain injury and contact sports history in standard medical history taking in general practice, neurology, psychiatry, forensic medicine, and other medical specialties.

• The Commonwealth and state and territory governments to explore how medical autopsy, including autopsy brain examination for CTE, can be better funded.

• The government to follow recommendations following the recent Senate inquiry.

RCPA president Dr Lawrie Bott acknowledged developing preventative strategies when understanding of a disease was evolving was challenging.

“However evidence for the need to act is clear,” he said in a statement.

“As a doctor, it worries me that we are continuing to expose boys and girls, and young men and women to lifelong devastating harm, when we already have significant evidence as a community.”

Associate Professor Michael Buckland said almost every patient diagnosed with CTE at autopsy in Australia had a history of repetitive head impacts.

“Perhaps even more disturbing is the large number of CTE cases, in both amateurs and professionals, who die from suicide,” the Sydney neuropathologist said.

“Unfortunately, in almost all cases of suicide in Australia, the brain is not examined. This could prevent families from getting the answers they need.

“It also worries me what we could be missing from a research perspective by not examining these brains. We need to establish better pathways for autopsy brain examination and/or donation for deaths where CTE is suspected.”

Meanwhile, research commissioned by the RCPA in October involving 1,001 respondents, revealed that 98% of those who watched contact sports were concerned about head knocks and 74% wanted preventative strategies in place.