The RACGP Guidelines for preventive activities in general practice, commonly known as the Red Book, is the RACGP’s guide to evidence-based preventive care in Australian general practice. It focuses mainly on asymptomatic people and on prevention, screening and case finding across the life course.
- What the Red Book is for
- General practice is central to prevention because most Australians see a GP regularly.
- The Red Book helps GPs decide what preventive activity to offer, to whom, and when.
- Recommendations consider benefit, harm, evidence, feasibility and health inequity.
- Prevention should be tailored to the individual rather than applied mechanically.
- Aboriginal and Torres Strait Islander people may require earlier or additional preventive activities.
- For expanded detail: Preventative Healthcare · ATSI Screening
- Screening, case finding and prevention
- Screening: testing asymptomatic people to identify those more or less likely to have a disease.
- Case finding: targeted testing when risk factors or clinical circumstances increase suspicion.
- Prevention: interventions intended to prevent disease, disability, progression or premature death.
- Screening is worthwhile when:
- the condition is important
- an identifiable early stage exists
- the natural history is understood
- the test is sufficiently accurate and acceptable
- effective treatment exists
- benefits outweigh harms.
- For expanded detail: Screening · Preventative Healthcare
- How prevention happens in general practice
- Opportunistic prevention: performed during consultations for another reason.
- Systematic prevention: recalls, registers and planned screening or vaccination programs.
- Consider both the benefits and harms of preventive interventions.
- Important harms include false positives, overdiagnosis, unnecessary investigation and treatment.
- Use shared decision-making where patient preferences materially affect the balance of benefit and harm.
- Do not order a screening test unless the result can reasonably change management.
- For expanded detail: General Check-up · Population Health / Preventative
- Cancer prevention and screening
- Covers breast, cervical, colorectal, prostate, skin and other cancers.
- The 10th edition also includes bladder, lung and thyroid cancer.
- Population screening should be distinguished from investigation of symptoms.
- Family history and individual risk may move a patient outside routine population screening pathways.
- For expanded detail: Cervical Cancer Screening · Colorectal Cancer Screening · Prostate Cancer Screening · Oncology · Dermatological Presentations
- Cardiovascular and metabolic prevention
- Assess absolute cardiovascular risk, not individual risk factors in isolation.
- Includes blood pressure, lipids, smoking, diabetes and other cardiovascular risk factors.
- The 10th edition includes updated sections on cardiovascular disease risk and atrial fibrillation.
- Metabolic prevention includes diabetes, nutrition, overweight/obesity, coeliac disease and thyroid disorders.
- For expanded detail: Cardiovascular Disease Screening · Cardiac Check-up · Atrial Fibrillation / Flutter · Diabetes Screening · Endocrine and Metabolic Health
- Immunisation and infectious disease prevention
- Check immunisation status and provide routine and catch-up vaccination where indicated.
- Consider additional vaccination according to age, pregnancy, Aboriginal and Torres Strait Islander status and medical risk.
- Infectious disease prevention includes hepatitis B, hepatitis C and HIV.
- For expanded detail: Immunisations · Hepatitis B · Hepatitis C · Infectious Diseases
- Children and development
- Preventive care includes growth, development, behaviour, hearing, vision, oral health, immunisation and safety.
- The 10th edition specifically includes developmental delay and autism.
- Genetic risk, counselling and testing are included where clinically appropriate.
- For expanded detail: Child and Youth Health / Paediatrics · Paediatrics
- Mental health, substance use and safety
- Includes depression, anxiety, suicide risk, eating disorders, gambling and perinatal mental health.
- Includes smoking, nicotine vaping and alcohol use.
- Injury prevention includes falls, bullying, child abuse and elder abuse.
- Prevention should include psychosocial as well as physical health.
- For expanded detail: Mental Health / Psychiatry · Smoking Cessation Medications · Falls Prevention · Abuse and Violence
- Musculoskeletal health
- Includes osteoporosis and fracture prevention.
- Childhood musculoskeletal topics include developmental dysplasia of the hip and scoliosis.
- Falls prevention is particularly important in older people.
- For expanded detail: Osteoporosis / Osteopenia · Musculoskeletal Presentations / Orthopaedics · Falls Prevention
- Reproductive and women’s health
- Includes preconception care, the first antenatal visit, interconception care and post-menopausal health.
- Preventive care includes reproductive planning, vaccination, screening, medication review and optimisation of chronic disease.
- For expanded detail: Pregnancy and Reproductive Health · Women’s Health · Menopause
- Older people and miscellaneous prevention
- Includes frailty, hearing, vision, oral health, sleep disorders and urinary incontinence.
- Preventive care should increasingly consider frailty, function, life expectancy, comorbidity and patient goals.
- For expanded detail: Older Persons Health / Geriatrics · Ear Health · Ophthalmology
- What changed in the 10th edition
- Uses a pragmatic meta-guideline approach incorporating GRADE principles rather than the previous NHMRC FORM framework.
- Chapters use more consistent headings and recommendation formats.
- New or substantially expanded topics include:
- bladder, lung and thyroid cancer
- atrial fibrillation and cardiovascular risk
- developmental delay and autism
- hepatitis B and C
- bullying, child abuse and elder abuse
- anxiety, eating disorders, gambling and perinatal mental health
- coeliac disease and thyroid disorders
- developmental dysplasia of the hip and scoliosis
- preconception, antenatal, interconception and post-menopausal care
- frailty and sleep disorders.
The practical message is simple: screen where evidence supports screening, find disease earlier where risk justifies case finding, prevent disease where possible, and avoid causing harm through unnecessary testing.