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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

IMPACT FACTOR 2018: 3.638

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SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

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Volume 54, Issue 12


Identifying risk in the use of tumor markers to improve patient safety

Elvira Eva Moreno-Campoy
  • Corresponding author
  • Pharmacy Unit, Health Management Area Serranía de Málaga, Carretera de El Burgo, km 1 29400 Ronda Málaga, Málaga, Spain
  • University of Málaga, Málaga, Spain
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Francisco J. Mérida-De la TorreORCID iD: http://orcid.org/0000-0002-1545-3665 / Francisco Martos-CrespoORCID iD: http://orcid.org/0000-0003-4585-5195 / Mario PlebaniORCID iD: http://orcid.org/0000-0002-0270-1711
Published Online: 2016-03-08 | DOI: https://doi.org/10.1515/cclm-2015-0760



Tumor markers (TM) are a routine test that are not always used well, and can lead to unnecessary additional tests, which are not without risks for the patients. So, to implement appropriate strategies to improve the adequate use of TM and, therefore, improve patient safety, is required to analyze the use of TM, identifying risks and establishing if there are differences in their use as a function of their utility.


The study was a descriptive, longitudinal, retrospective and systematic study in the area covered by the University Hospital of Padua. In the follow-up 2-year study, 23,059 analytical requests of TM, corresponding to 14,728 patients, were analyzed. For the level of statistical significance it applies an approximation of the normal law (Z statistic) and χ2-test.


Only 9196 requests (39.88%) out of a total of 23,059 on 5080 patients with neoplastic diseases have been classified as adecuate according to current guidelines. The number of requests per patient was variable (1.57±1.35). In patients with neoplastic diseases this increased to 1.80±1.68. The mean of number of TM per request was 2.4±1.73. The analysis showed an association between the number of requests and the type of marker used.


The use of TM is variable, mainly of the follow-up markers, when they are used as screening. This inappropriate use, minimizes their utility favoring erroneous interpretations and increases the risk of damage to the patient. So it is essential to implement safe practices in the use of TM.

Keywords: biomarkers tumor; clinical medicine; effectiveness; patient safety; risk assessment; tumor markers; utility


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About the article

Corresponding author: Elvira Eva Moreno-Campoy, Pharmacy Unit, Health Management Area Serranía de Málaga, Carretera de El Burgo, km 1 29400 Ronda Málaga, Málaga, Spain, Phone: +34677904018, E-mail: ; and University of Málaga, Málaga, Spain

Received: 2015-08-05

Accepted: 2016-01-26

Published Online: 2016-03-08

Published in Print: 2016-12-01

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 54, Issue 12, Pages 1947–1953, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2015-0760.

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