ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2015
Tumor marker usage and medical care costs among older early-stage breast cancer survivors.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Clinicopathological and Prognostic Significance of Cancer Antigen 15-3 and Carcinoembryonic Antigen in Breast Cancer: A Meta-Analysis including 12,993 Patients.Disease markers · 2018Pooled it
- Overuse of Health Care Services in the Management of Cancer: A Systematic Review.Medical care · 2017Pooled it
- Primary care provider attitudes about and tendency to use non-recommended surveillance tests after curative breast cancer treatment.Breast cancer research and treatment · 2023Article
- Establishment and validation of reference intervals for tumor markers (AFP, CEA, CA19-9, CA15-3, CA125, PSA, HE4, Cyfra 21-1, and ProGRP) in primary care centers in Korea: A cross-sectional retrospective study.Health science reports · 2023Article
- Strategies for de-implementation of low-value care-a scoping review.Implementation science : IS · 2022Article
- Diagnostic and prognostic significance of SLC50A1 expression in patients with primary early breast cancer.Experimental and therapeutic medicine · 2022Article
- Assessing surveillance utilization and value in commercially insured patients with colorectal cancer.The American journal of managed care · 2022Article
- Adjuvant Treatment of Elderly Breast Cancer Patients: Offer the Best Chances of Cure.Breast care (Basel, Switzerland) · 2022Review
- Circulating tumor cells in the early detection of human cancers.International journal of biological sciences · 2022Review
- Changes of Tumor Markers in Patients with Breast Cancer during Postoperative Adjuvant Chemotherapy.Disease markers · 2022Article
- Determinants for the use and de-implementation of low-value care in health care: a scoping review.Implementation science communications · 2021Article
- Association of Serum Progranulin Levels With Disease Progression, Therapy Response and Survival in Patients With Metastatic Breast Cancer.Clinical breast cancer · 2020Observational
- Updated Overview of the SEER-Medicare Data: Enhanced Content and Applications.Journal of the National Cancer Institute. Monographs · 2020Review
- Analysis of blood markers for early breast cancer diagnosis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2018Observational
- Article
- An individual reference limit of the serum CEA-TPA-CA 15-3 tumor marker panel in the surveillance of asymptomatic women following surgery for primary breast cancer.Cancer management and research · 2018Article
- Future cancer research priorities in the USA: a Lancet Oncology Commission.The Lancet. Oncology · 2017Review
- Association between survival time with metastatic breast cancer and aggressive end-of-life care.Breast cancer research and treatment · 2017Article
- Identification of Biomarkers for Breast Cancer Using Databases.Journal of cancer prevention · 2016Review
- Use and Costs of Disease Monitoring in Women With Metastatic Breast Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2016Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
purposeAlthough American Society of Clinical Oncology guidelines discourage the use of tumor marker assessment for routine surveillance in nonmetastatic breast cancer, their use in practice is uncertain. Our objective was to determine use of tumor marker tests such as carcinoembryonic antigen and CA 15-3/CA 27.29 and associated Medicare costs in early-stage breast cancer survivors.
methodsBy using Surveillance, Epidemiology, and End Results-Medicare records for patients diagnosed with early-stage breast cancer between 2001 and 2007, tumor marker usage within 2 years after diagnosis was identified by billing codes. Logistic regression models were used to identify clinical and demographic factors associated with use of tumor markers. To determine impact on costs of care, we used multivariable regression, controlling for other factors known to influence total medical costs.
resultsWe identified 39,650 eligible patients. Of these, 16,653 (42%) received at least one tumor marker assessment, averaging 5.7 tests over 2 years, with rates of use per person increasing over time. Factors significantly associated with use included age at diagnosis, diagnosis year, stage at diagnosis, race/ethnicity, geographic region, and urban/rural status. Rates of advanced imaging, but not biopsies, were significantly higher in the assessment group. Medical costs for patients who received at least one test were approximately 29% greater than costs for those who did not, adjusting for other factors.
conclusionBreast cancer tumor markers are frequently used among women with early-stage disease and are associated with an increase in both diagnostic procedures and total cost of care. A better understanding of factors driving the use of and the potential benefits and harms of surveillance-based tumor marker testing is needed.
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