An epidemiology-based model as a tool to monitor the outbreak of inappropriateness in tumor marker requests: A national scale study

Massimo Gion, Lucia Peloso, Chiara Trevisiol, Elisa Squarcina, Marco Zappa, Aline S C Fabricio

Research output: Contribution to journalArticle

Abstract

Background: Evaluation of appropriateness of laboratory tests on the basis of individual requests remains a serious problem as the clinical question is usually not reported with the test order. This study explored the comparison of the rate of tumor marker orders with cancer prevalence as a putative indicator of inappropriateness. Methods: Tumor marker orders (2011 and 2012) were obtained from the Ministry of Health and cancer prevalence from the Italian Association of Cancer Registries. The rate of tumor marker orders was matched with demographic data and tumor prevalence and examined by using the confidence interval approach. Region-to-region and year-to-year variations were also examined. Focus was placed on CEA, CA125, CA19.9 and CA15.3. Results:Tumor markers ordered in Italy were 13,207,289 in 2012 (221.3/1000 individuals). Given an estimated prevalence of 2,243,953 cancer cases, 7.04 tumor markers appear to be requested for each prevalent case of epithelial cancer per year. The rate of requests of CEA, CA125, CA19.9 and CA15.3 (in aggregate 5,834,167 requests in 2012, 44.2% of total) from the first and the last ranked region (96 and 244/1000 individuals) are significantly different (p

Original languageEnglish
Pages (from-to)473-482
Number of pages10
JournalClinical Chemistry and Laboratory Medicine
Volume54
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

Keywords

  • appropriateness
  • biomarkers
  • epidemiology
  • oncology
  • prevalence

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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