Not What The Doctor Ordered

The hidden costs of medical testing

- Carine Abouseif

A patient bursts into the hos-pital, upset, convinced she has ovarian cancer. She says she has proof: a blood test, ordered by her family doctor, shows elevated amounts of CA125, a protein sometimes found on cancerous cells. But the emergency doctors learn that neither the patient nor her immediate family members have histories of ovarian cancer, which means she should never have undergone the test in the first place: it is not designed for the general population. The patient had heard about the test and asked her own physician to perform it, just in case, setting off a chain of events that led her to the hospital.

Raj Waghmare, an emergency-room doctor in Newmarket, Ontario, says he has repeatedly seen situations like this one — patients rushing to the ER after receiving unnecessary lab results. CA125 testing is most often recommended for women who have or are suspected to have ovarian cancer: it can help determine whether a treatment is working or the cancer has reappeared. But, when used to screen patients who don’t have that history, it can deliver false positives, leading to unwarranted panic and interventions. After conducting a pelvic ultrasound, hospital staff assured the patient that she was fine and sent her home.