ASSESSING THE FREQUENCY OF CA-125 MEASUREMENTS WITHIN HAMILTON HEALTH SCIENCES AND ST. JOSEPH’S HEALTHCARE

Objective To determined if the number and frequency of CA-125 measurements per patient reflect the 2008 NACB (National Academy of Clinical Biochemist) practice guidelines. Methods We collected data retrospectively on CA-125 over a period of one year as apart of our ongoing practice in monitoring the tumor markers for quality assurance, The number of CA-125 results per patient as well as the time interval between the 1st and 2nd measurements was noted. To enrich this population for the likelihood that the measurement of CA-125 was used for monitoring or for detection of recurrence, we divided the population into patients from the Jurvainski Cancer Centre (JCC) and the rest of the sites. Results The JCC patients contributed the majority of CA-125 results, representing over 75% of all results (n= 3057 results from 998 patients), whereas the remainder of the sites only yielded 959 results from 920 patients. Further analysis of the JCC patients indicated 2 main subgroups: Group A – patients with 1 or 2 results (n=624 patients); Group B - patients with 3 or more results , Overall, less than 4% of patients at the JCC had a time interval between the 1st and 2nd specimens of less than 2 weeks. Discussion This initial analysis would indicate that physicians are ordering CA-125 in agreement with the NACB guidelines. To further improve compliance to the guidelines and to prevent subsequent measurements of CA-125 too close, we propose restricting CA-125 orders that are less than 14 days apart to only those that receive Biochemist’s approval.