How CA 125 Is Used in the Routine Follow-Up of Ovarian Cancer:A Survey of 29 Italian Hospitals

Tumor markers are currently monitored on a routine basis. However, their impact on the course of a disease is still under debate. This relative uncertainty leads to a subjective approach to their use. In order to evaluate the range in the pattern of tumor marker application we carried out a survey on the follow-up of patients with ovarian, breast, and colorectal carcinomas. This report concerns only ovarian cancer. Preliminary results showed that the number of markers used, the cutoff point and, probably of major importance, the management of patients with positive tumor marker vary considerably. When evaluating the institutional setting of the surveyed hospitals, a relatively poor interaction between clinicians and the laboratory staff was found. Actually, in about half of the investigated centers, clinical information is not provided to the laboratory staff and methodological aspects are not reported to clinicans, too. The first step to increase the effectiveness of tumor markers is to improve cooperation between persons assaying the markers and those using them. This is a mandatory task in order to both enable the application of recommendations provided by guidelines and to provide the means to verify their rate of acceptance.