Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath
Consultant Chemical Pathologist
The comment accompanying CA125 report could even be simpler:
"Please follow NICE guidance 122 for recognition and
initial management of ovarian cancer."
Really unless GPs follow the full guidance, there is little
we can add from looking at sketchy clinical details and a
numerical CA125 result.
Regards
Mohammad
Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath
Consultant Chemical Pathologist
>
>
> --- On Wed, 20/7/11, Anne Dawnay <[log in to unmask]>
> wrote:
>
> > From: Anne Dawnay <[log in to unmask]>
> > Subject: CA125 in symptomatic women presenting to
> primary care
> > To: [log in to unmask]
> > Date: Wednesday, 20 July, 2011, 10:50
> > I really don't think we should be
> > referring to this as 'screening' - it
> > isn't. GPs are assessing symptoms all the time and
> > requesting tests that
> > may be of value in the differential diagnosis - I
> suppose
> > one could say
> > they are 'screening' for disease all the time but I
> don't
> > think that is
> > a helpful term to use. It is not at all like the
> colon
> > cancer screening
> > programme.
> >
> > The labs in the North Central London sector are
> pooling
> > data on GP CA125
> > total requesting numbers and those with results of 35
> or
> > more. We're
> > looking at the pattern from March 1st - looks like we
> may
> > have had a
> > peak in the few weeks post guideline (expect lots of
> women
> > read the
> > papers and trotted off to their GP) that has now
> settled -
> > should become
> > clearer by the end of the month. This is being fed
> back to
> > gynae onc
> > ultrasound services that should be seeing the same
> pattern
> > slightly
> > later. I believe they are planning some educational
> > sessions in
> > September.
> >
> > At UCLH the LIMS automatically appends the following
> to any
> > primary care
> > CA125 result - aims to be brief but informative:
> >
> > www.nice.org.uk/CG122 If symptoms suggest ovarian
> > cancer and CA125 is 35 kIU/L or more, refer for
> > ultrasound (NICE 2011). Disease not excluded if
> > <35 kIU/L, assess clinically.
> >
> >
> > best wishes
> > Anne
> > Dr Anne Dawnay PhD FRCPath
> > Consultant Biochemist, UCLH
> > 08451555000 ext 2954
> >
> >
> > Date: Tue, 19 Jul 2011 10:09:59 +0100
> > From: Jonathan Kay <[log in to unmask]>
> > Subject: CA125 and screening for ovarian cancer
> >
> > Thanks, Mike.
> >
> > But the case for the new approach to screening for
> ovarian
> > cancer is
> > well documented in the NICE supporting evidence. For
> these
> > difficult
> > calls isn't it now necessary to do this on a basis of
> > decision analysis
> > and economic analysis?
> >
> > I think that it's going to work well in practice. The
> bit
> > I'm worried
> > about is local variation in process and information
> > management. To the
> > best of my knowledge it won't have a programme
> management
> > structure
> > similar to that which is working well for screening
> for
> > colorectal
> > cancer.
> >
> > Is anyone running local educational sessions on how to
> do
> > this well?
> >
> > Jonathan
> >
> >
> >
> >
> >
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