Serum tumor markers: A study on their rational use in various cancers

Abstract

Background: Cancer is among the leading noncommunicable diseases and its screening, diagnosis, management, monitoring, and relapse involve the use of tumor markers. Tumor marker requisition adds to a major financial burden if not used rationally. Aim and Objectives: The aim was to study the rational use of tumor markers in various cancers with objectives to do requisition analysis of tumor markers with the existing national guidelines by the Indian Council of Medical Research (ICMR) and to assess its financial impact. Materials and Methods: A total of 355 cases were screened and 221 were included in the study. The patient's laboratory requisition form raised by the ordering physician as a part of the screening, diagnosis, management, monitoring, and relapse for different conditions including cancers were studied retrospectively over a period of 5 months, and data were analyzed. Results: Two hundred and twenty-one requisitions for various tumor markers were ordered for screening, diagnosis, management, monitoring, and relapse of various cancers and other conditions. Only 10%–30% of requisitions were found as per the laid down guidelines of the ICMR for different cancers. Carcinoembryonic antigen was ordered in only 20% requisitions as per the ICMR guidelines but has affected maximally in terms of test cost by adding up 88% to the budget of the test. Conclusion: Rational use of tumor markers in different cancers can cut down the cost factor directly. It prevents the physician in overdiagnosing due to multiple requisitions in diagnosed cancers and hence avoiding undue medical procedures thus further reducing the financial burden on the patients and their family.

Keywords

• diagnosis
• financial burden
• requisitions
• tumor markers