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November 2016

Routine Cancer Antigen 125 Surveillance—The Fatal Attraction of Testing

Author Affiliations
  • 1Department of Medicine and Sealy Center on Aging, University of Texas Medical Branch, Galveston
JAMA Oncol. 2016;2(11):1412-1413. doi:10.1001/jamaoncol.2016.2032

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?