How CA 125 is used in routine clinical practice

The only role where the CA 125 test has proven utility is: (i) for monitori ng ovarian cancer (OC); and (ii) for a preoperative test in patients with a n ovarian mass. The aim of our study was to assess the clinical indications for CA 125 determinations in order to estimate the appropriateness of CA 1 25 use. During the period of 1 August 1993 through 31 December 1995 all CA 125 assays performed at the laboratory of the Institut Central des Hopitaux Valaisans (ICHV) and the data of the patients receiving these tests were a udited in order to identify the clinical indication for the test. We have c onsidered as 'correct indication' a CA 125 test performed: (i) during follo w-up monitoring of patients having an OC and; (ii) as a preoperative test o f a suspect ovarian mass. 462 patients have received a total of 1057 CA 125 assays. 84 (18%) patients have received 537 (51%) tests for monitoring OC and 68 (15%) patients, 68 tests (6%) as a preoperative evaluation for an ov arian mass. 310/462 (67%) other patients have received 452/1057 (43%) CA 12 5 tests for screening purposes in various clinical situations. Therefore, o nly 33% (152/462) patients including 57% (605/1057) of tests, had CA 125 as sessments done for the correct indication. The current pattern of practice shows that a great number of CA 125 requests were inappropriate. Educationa l actions aimed at laboratory users concerning the optimal use of CA 125 sh ould be considered in order to develop a more rational approach. (C) 2000 E lsevier Science Ltd. All rights reserved.