Extent and cost of inappropriate use of tumour markers in patients with pulmonary disease: a multicentre retrospective study in Shanghai, China

Objectives: The currently implemented healthcare reform in China requires substantial capital investment. Although overtreatment results in serious waste, inappropriate laboratory use is widespread, and overuse of tumor markers (TMs) has attracted increasing attention. Design: Retrospective study. Setting: The respiratory, thoracic surgery, and oncology departments of three hospitals in Shanghai, from 2014 to 2015. Participants: Patients with chronic obstructive pulmonary disease (COPD) and primary bronchogenic lung cancer (PLC). Based on clinical guidelines and physician experience, the criteria of suitability of TM examinations were determined, and the number, cost, and proportion of inappropriate TM requests were analyzed. Results: The area under the receiver operating characteristic (ROC) curve for CEA+CYFRA211+SCC+NSE in COPD and PLC patients was 0.813, in accordance with the cost-effectiveness principle, indicating good clinical and health economics values. In the 2706 patients, 1...