Around 106,239 patients are newly diagnosed with solid metastatic tumours per year in the United States. The study focused on evaluating the frequency of tumour marker use in patients with advanced solid tumours.
Many limitations exist related to the use of tumour markers for screening and early detection, like lack of sensitivity (50% to 90%) and specificity (46% to 90%). The study focused on performing a retrospective analysis to evaluate the frequency of serum tumour marker use.
The study consisted of all patients with the following serum tests done: α-fetoprotein, CA-125, CA 15-3, CA 19-9, CA 27-29 carcinoembryonic antigen (CEA).
Around 2,223 patients with breast, colorectal, ovarian, lung, pancreatic, or hepatobiliary cancer were treated as outpatients at the Herbert Irving Cancer Center at Columbia University between July 1, 2013, to June 30, 2014. Of these, 928 patients had advanced disease. The most common cancer types were hepatobiliary (34.8%), pancreatic (24.1%), and breast (15.7%). Of the 1,573 total number of serum tumour marker tests performed over the study period, 1,441 (91.6%) were disease-specific, and 132 (8.4%) were not.
This was a 1-year evaluation of tumour marker use at a single institution. In summary, we found a high rate of serum tumour marker testing overuse and extreme overuse in patients with advanced solid tumours. Future research should define the minimal frequency of testing and determine whether the response can reduce more expensive radiologic tumour imaging.