Chair: Dr Helen Falconer, Consultant Clinical Scientist (NHS Greater Glasgow & Clyde)
Vice-Chair: Mrs Janet Hogg, Consultant Clinical Scientist (NHS Ayrshire & Arran)
Background
Serum tumour marker measurement can aid cancer management in a number of ways, including in screening, diagnosis, prognostic assessment and/or post-treatment monitoring. Audits repeatedly highlight differences in reference intervals and decision limits, reporting practice and interpretation of tumour marker results that may contribute to variation in clinical practice. The main purpose of this group is to collaborate with clinical colleagues to reduce such variation, an aim that aligns well with the National Clinical Strategy for Scotland.
Aims of the Subgroup include:
- Reviewing current serum tumour marker provision in Scotland.
- Encouraging adoption of nationally agreed decision levels for prostate specific antigen (PSA)
- Auditing CA125 requesting patterns against the Scottish Cancer Referral Guidelines for the early detection of ovarian cancer.
- Updating and reissuing the Tumour Marker bookmark which provides guidance on appropriate requesting
- Establishing and maintaining good links with the three regional Cancer Networks.
Scottish Cancer Network Contacts
| Cancer Network | Boards | Link Contact | Contact details |
|---|---|---|---|
| North Cancer Alliance(Link) | Grampian, Highland, Orkney, Shetland, Tayside, Western Isles | Karen Rankin | karen.rankin1@nhs.scot |
| South East Scotland Cancer Network (SCAN)(Link) | Borders, Dumfries & Galloway, Fife, Lothian | Cathie SturgeonRebecca Pattenden | c.sturgeon@ed.ac.ukrebecca.pattenden@nhslothian.scot.nhs.uk |
| West of Scotland Cancer Network (WoSCAN)(Link) | Ayrshire & Arran, Forth Valley, Greater Glasgow & Clyde, Lanarkshire | Helen FalconerJanet Hogg | helen.falconer3@ggc.scot.nhs.ukjanet.hogg2@aapct.scot.nhs.uk |
Progress
- Links have been established with the three Scottish Cancer Networks, NOSCAN, SCAN and WoSCAN and the Scottish Primary Care Cancer Group, facilitating the following activities:
CA 19-9 and CA 15-3 Service Provision in Scotland
The Cancer Subgroup have developed a series of recommendations on the use of CA 15-3 and CA 19-9 testing in Scotland.
CA15-3 / CA19-9 Recommendations
CA125 Audit Report
The Scottish Clinical Biochemistry Network (SCBN) is leading on a piece of national work entitled ‘Audit of current practice in primary care for investigation of women presenting with symptoms which may be due to ovarian cancer’. Following a pilot study in NHS GG&C, the audit was rolled out to all NHS Scotland boards to gain a national picture. The audit findings were presented at the SCBN Education Day in autumn 2019, to the SCIN steering group in January 2020, and has also been shared with the Scottish Primary Care Cancer Group. The report will also be shared with the regional cancer networks. A poster on the work has been accepted to the next ACB National Meeting (rescheduled to March 2020, Belfast)
Review of tumour marker service provision
- Reference ranges and/or decision limits currently provided by Scottish laboratories and those used in clinical practice have been harmonised across Scotland.
- Service provision of the specialist tumour markers CA 19-9 and CA 15-3 have been re-surveyed across Scotland to determine scope for further harmonisation and to retain testing within NHS Scotland laboratories where possible. Recommendations on testing will also include typical indications for use of these markers.
- Currently developing a resource of small volume tumour marker testing services in Scotland and UK-wide.
Tumour Marker Bookmark
- Download the Tumour Marker Bookmark here
- Now formally endorsed by the Royal College of Pathologists, Realistic Medicine programme, and the IBMS.
- Physical bookmarks made available to all laboratory contacts for the territorial health boards and physical / electronic copies sent to all GPs or GP practices in 7 out of 9 health boards. A link to the bookmark has also been made available on most hospital websites or intranets.
- Emailed directly to the clinical lead for the West of Scotland Primary Cancer Care Network for onward distribution to Primary Care Cancer leads.
- Recommendations:
- Continue to highlight primary care links (including clinical leads for the other primary cancer care networks in Scotland).
- Encourage laboratory contacts in remaining NHS Scotland boards to send out bookmark (either physical or electronic) to primary care. This will include the link to the electronic copy on the SCBN website, which also serves to highlight the network to service users.