Routine cancer antigen 125 surveillance—the fatal attraction of testing
Menée aux Etats-Unis sur une cohorte de 1 241 patientes atteintes d'un cancer de l'ovaire en phase de rémission après une chirurgie cytoréductive et une chimiothérapie réalisées entre 2004 et 2011 (âge moyen : 59 ans), cette étude multicentrique analyse l'utilisation, dans le cadre d'une surveillance médicale, des tests CA-125 et de la tomographie numérique avant et après la diffusion en 2009 des résultats d'un essai clinique démontrant l'inefficacité et le coût élevé de ces outils
The article by Esselen et al1 in this issue of JAMA Oncology belongs to the category of health services research that asks how the introduction of new evidence influences clinical practice. In the instance they examined—publication of a study that showed routine cancer antigen 125 (CA-125) surveillance was harmful—the answer seems to be “not at all.” In the 6 NCI-designated cancer centers they studied, the use and frequency of CA-125 testing of women in remission after initial treatment for ovarian cancer was similar in the years before and after the study. In both periods, almost all such patients received CA-125 testing approximately every 3 to 4 months. This is actually quite a remarkable observation. Why did practice not change?
JAMA Oncology , éditorial, 2015