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Tumour marker requesting in primary care and the role of the laboratory
  1. Patrick L C Walker,
  2. Martin Crook
  1. Department of Clinical Biochemistry, University Hospital Lewisham, London, UK
  1. Correspondence to Mr Patrick Walker, Department of Chemical Pathology, St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK; patrick.walker{at}gstt.nhs.uk

Abstract

Aims To review the incidence of multiple tumour marker (TM) requesting in the primary care setting and determine whether the rationale for requesting a TM panel is in agreement with evidence-based guidelines.

Methods Data-mining software was used to retrospectively identify multiple TM requests and requesting practices of GP surgeries over a 34-month period for α-fetoprotein, CA125, CA15-3, CA19-9, carcinoembryonic antigen and prostate-specific antigen. The appropriateness of each test was reviewed by a clinical biochemist in accordance with National Association of Clinical Biochemistry best-practice guidelines.

Results 505 multiple TM requests were identified which corresponded to 1304 TM tests. Comparison with best-practice guidelines suggested that 68% of request cards contained no appropriate TM request, and 84% of the tests requested were inappropriate.

Conclusion A review of requesting practices in primary care for TMs highlights the need for laboratories to be more proactive in educating their users on their clinical utility and limitations.

  • Tumour marker
  • education

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.