Stollberg, Sabrina M; Näpflin, Markus; Nagler, Michael; Huber, Carola A (2023). Are Tumor Marker Tests Applied Appropriately in Clinical Practice? A Healthcare Claims Data Analysis. Diagnostics, 13(21) MDPI 10.3390/diagnostics13213379
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Tumor markers (TM) are crucial in the monitoring of cancer treatment. However, inappropriate requests for screening reasons have a high risk of false positive and negative findings, which can lead to patient anxiety and unnecessary follow-up examinations. We aimed to assess the appropriateness of TM testing in outpatient practice in Switzerland. We conducted a retrospective cohort study based on healthcare claims data. Patients who had received at least one out of seven TM tests (CEA, CA19-9, CA125, CA15-3, CA72-4, Calcitonin, or NSE) between 2018 and 2021 were analyzed. Appropriate determinations were defined as a request with a corresponding cancer-related diagnosis or intervention. Appropriateness of TM determination by patient characteristics and prescriber specialty was estimated by using multivariate analyses. A total of 51,395 TM determinations in 36,537 patients were included. An amount of 41.6% of all TM were determined appropriately. General practitioners most often determined TM (44.3%) and had the lowest number of appropriate requests (27.8%). A strong predictor for appropriate determinations were requests by medical oncologists. A remarkable proportion of TM testing was performed inappropriately, particularly in the primary care setting. Our results suggest that a considerable proportion of the population is at risk for various harms associated with misinterpretations of TM test results.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry |
UniBE Contributor: |
Nagler, Michael |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2075-4418 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
15 Nov 2023 12:38 |
Last Modified: |
15 Nov 2023 12:45 |
Publisher DOI: |
10.3390/diagnostics13213379 |
PubMed ID: |
37958275 |
Uncontrolled Keywords: |
guideline adherence healthcare claims data inappropriateness laboratory testing overutilization tumor marker determination |
BORIS DOI: |
10.48350/188919 |
URI: |
https://boris.unibe.ch/id/eprint/188919 |
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