1997 update of recommendations for the use of tumor markers in breast and colorectal cancer. Adopted on November 7, 1997 by the American Society of Clinical Oncology.

1998 ◽  
Vol 16 (2) ◽  
pp. 793-795 ◽  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Clinical Practice ◽  
Clinical Oncology ◽  
Tumor Markers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Disease Free Survival ◽  
Research Committee ◽  
American Society

OBJECTIVE The primary objective was to update the 1996 clinical practice guidelines for the use of tumor marker tests in the prevention, screening, treatment, and surveillance of breast and colorectal cancers. These guidelines are intended for use in the care of patients outside of clinical trials. OPTIONS Six tumor markers for colorectal cancer and eight for breast cancer were considered. They could be recommended or not for routine use or for special circumstances. In addition to carcinoembryonic antigen (CEA) and cancer antigen (CA) 15-3, CA 27.29 also was considered in regard to circulatory tumor markers for breast cancer. OUTCOMES In general, the significant health outcomes identified for use in making clinical practice guidelines (overall survival, disease-free survival, quality of life, lesser toxicity, and cost effectiveness) were used. EVIDENCE A computerized literature search from 1994 to July 1997 was performed. VALUES The same values for Use, Utility, and Levels of Evidence were used by the Committee. BENEFITS, HARMS, AND COSTS The same benefit, harms, and costs were used. RECOMMENDATION No changes in any guidelines were recommended (see text). VALIDATION External review by the American Society of Clinical Oncology (ASCO) Health Services Research Committee and by ASCO Board of Directors. SPONSOR American Society of Clinical Oncology.

2000 Update of Recommendations for the Use of Tumor Markers in Breast and Colorectal Cancer: Clinical Practice Guidelines of the American Society of Clinical Oncology*

2001 ◽  
Vol 19 (6) ◽  
pp. 1865-1878 ◽  
Author(s):  
Robert C. Bast ◽  
Peter Ravdin ◽  
Daniel F. Hayes ◽  
Susan Bates ◽  
Herbert Fritsche ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Clinical Practice ◽  
Clinical Oncology ◽  
Tumor Markers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Disease Free Survival ◽  
Research Committee ◽  
American Society

OBJECTIVE: To update the 1997 clinical practice guidelines for the use of tumor marker tests in the prevention, screening, treatment, and surveillance of breast and colorectal cancers. These guidelines are intended for use in the care of patients outside of clinical trials. OPTIONS: Six tumor markers for colorectal cancer and eight for breast cancer were considered. They could be recommended or not for routine use or for special circumstances. In addition to carcinoembryonic antigen (CEA) and CA 15-3, CA 27.29 was also considered among the serum tumor markers for breast cancer. OUTCOMES: In general, the significant health outcomes identified for use in making clinical practice guidelines (overall survival, disease-free survival, quality of life, lesser toxicity, and cost-effectiveness) were used. EVIDENCE: A computerized literature search from 1994 to March 1999 was performed. VALUES: The same values for use, utility, and levels of evidence were used by the committee. BENEFITS, HARMS, AND COSTS: The same benefit, harms, and costs were used. RECOMMENDATION: Changes were recommended (see Appendix). VALIDATION: The updated recommendations were validated by external review by the American Society of Clinical Oncology’s (ASCO’s) Health Services Research Committee and by ASCO’s Board of Directors. SPONSOR: American Society of Clinical Oncology.

Clinical practice guidelines for the use of tumor markers in breast and colorectal cancer. Adopted on May 17, 1996 by the American Society of Clinical Oncology.

1996 ◽  
Vol 14 (10) ◽  
pp. 2843-2877 ◽  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Clinical Practice ◽  
Tumor Markers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Disease Free Survival ◽  
Dna Index ◽  
Flow Cytometric ◽  
Published Evidence

PURPOSE The primary objective was to determine clinical practice guidelines for the use of tumor marker tests in the prevention, screening, treatment, and surveillance of breast and colorectal cancers. These guidelines are intended for use in the care of patients outside of clinical trials. METHODS Six tumor markers for colorectal cancer and seven for breast cancer were considered. They could be recommended or not for routine use or for special circumstances. In general, the significant health outcomes identified for use in making clinical practice guidelines (overall survival, disease-free survival, quality of life, lesser toxicity, and cost-effectiveness) were used when data were available. Expert consensus was used to inform the recommendations for use of tumor markers when published evidence was insufficient. A computerized literature search was performed using Medline. In addition to reports collected by individual panel members, all articles published in the English-speaking literature from January 1989 to April 1994 were collected for review and distributed to all members of the Panel. Values for use, utility, and levels of evidence were assigned by the expert reviewers and approved by the Panel. Tumor markers were assigned benefit if they had prognostic or predictive value that would lead to the favorable outcomes listed above. Harms considered were inappropriate disease management, and excess cost without definable benefit. Costs were considered but were never the sole determinant of a recommendation. RESULTS AND CONCLUSION For colorectal cancer, it is recommended that carcinoembryonic antigen (CEA) levels be measured preoperatively if it would change surgical management. It is recommended that CEA levels be monitored every 2 to 3 months for > or = 2 years, if resection of liver metastasis would be clinically indicated. The data are insufficient to recommend the routine use of lipid-associated sialic acid (LASA), CA 19-9, DNA index, DNA flow cytometric proliferation analysis, p53 tumor suppressor gene, and ras oncogene. For breast cancer, estrogen receptor and progesterone receptor are recommended to be measured on every primary specimen, but on subsequent specimens only if it would lead to a change in management. The data are insufficient to recommend the routine use of DNA index, DNA flow cytometric proliferation analysis, CA 15-3, CEA, c-erbB-2, p53 or cathepsin-D. In the absence of readily measurable disease, CA 15-3 and CEA levels can be used to document treatment failure. New markers and new evidence will be evaluated by annual update of these guidelines.

American Society of Clinical Oncology 1998 Update of Recommended Breast Cancer Surveillance Guidelines

1999 ◽  
Vol 17 (3) ◽  
pp. 1080-1080 ◽  
Author(s):  
Thomas J. Smith ◽  
Nancy E. Davidson ◽  
David V. Schapira ◽  
Eva Grunfeld ◽  
Hyman B. Muss ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Oncology ◽  
Expert Panel ◽  
Cancer Recurrence ◽  
Disease Free Survival ◽  
Cancer Surveillance ◽  
Surveillance Strategy ◽  
Research Committee ◽  
Services Research ◽  
American Society

OBJECTIVE: To determine an effective, evidence-based, postoperative surveillance strategy for the detection and treatment of recurrent breast cancer. Tests are recommended only if they have an impact on the outcomes specified by American Society of Clinical Oncology (ASCO) for clinical practice guidelines. POTENTIAL INTERVENTION: All tests described in the literature for postoperative monitoring were considered. In addition, the data were critically evaluated to determine the optimal frequency of monitoring. OUTCOME: Outcomes of interest include overall and disease-free survival, quality of life, toxicity reduction, and secondarily cost-effectiveness. EVIDENCE: A search was performed to determine all relevant articles published over the past 20 years on the efficacy of surveillance testing for breast cancer recurrence. These publications comprised both retrospective and prospective studies. VALUES: Levels of evidence and guideline grades were rated by a standard process. More weight was given to studies that tested a hypothesis directly relating testing to one of the primary outcomes in a randomized design. BENEFITS, HARMS, AND COSTS: The possible consequences of false-positive and -negative tests were considered in evaluating a preference for one of two tests providing similar information. Cost alone was not a determining factor. RECOMMENDATIONS: The attached guidelines and text summarize the updated recommendations of the ASCO breast cancer expert panel. Data are sufficient to recommend monthly breast self-examination, annual mammography of the preserved and contralateral breast, and a careful history and physical examination every 3 to 6 months for 3 years, then every 6 to 12 months for 2 years, then annually. Data are not sufficient to recommend routine bone scans, chest radiographs, hematologic blood counts, tumor markers (carcinoembryonic antigen, cancer antigen [CA] 15-5, and CA 27.29), liver ultrasonograms, or computed tomography scans. VALIDATION: The recommendations of the breast cancer expert panel were evaluated and supported by the ASCO Health Services Research Committee reviewers and the ASCO Board of Directors. SPONSOR: American Society of Clinical Oncology.

Recommended breast cancer surveillance guidelines. American Society of Clinical Oncology.

1997 ◽  
Vol 15 (5) ◽  
pp. 2149-2156 ◽  
Keyword(s):  
Breast Cancer ◽  
Clinical Oncology ◽  
Expert Panel ◽  
Disease Free Survival ◽  
Cancer Surveillance ◽  
Surveillance Strategy ◽  
Research Committee ◽  
Services Research ◽  
Levels Of Evidence ◽  
American Society

OBJECTIVE To determine an effective, evidence-based postoperative surveillance strategy for the detection and treatment of recurrent breast cancer. Tests are recommended only if they have an impact on the outcomes specified by the American Society of Clinical Oncology (ASCO) for clinical practice guidelines. POTENTIAL INTERVENTION: All tests described in the literature for postoperative monitoring were considered. In addition, the data were critically evaluated to determine the optimal frequency of monitoring. OUTCOME Outcomes of interest include overall and disease-free survival, quality of life, toxicity reduction, and secondarily cost-effectiveness. EVIDENCE A search was performed to determine all relevant articles published over the past 20 years on the efficacy of surveillance testing for breast cancer recurrence. These publications comprised both retrospective and prospective studies. VALUES Levels of evidence and guideline grades were rated by a standard process. More weight was given to studies that tested a hypothesis that directly related testing to one of the primary outcomes in a randomized design. BENEFITS/HARMS/COSTS: The possible consequences of false-positive and negative tests were considered in evaluating a preference for one of two tests that provided similar information. Cost alone was not a determining factor. RECOMMENDATIONS The attached guidelines summarize the recommendations of the ASCO breast cancer expert panel (see Table 1 for a summary of guidelines and corresponding levels of evidence and grades of recommendation). Data are sufficient to recommend monthly breast self-examination, annual mammography of the preserved and contralateral breast, and a careful history and physical examination every 3 to 6 months for 3 years, then every 6 to 12 months for 2 years, then annually. Data are not sufficient to recommend routine bone scans, chest radiographs, hematologic blood counts, tumor markers (CEA, CA15-5), liver ultrasonograms, or computed axial tomographic scans. VALIDATION The recommendations of the breast cancer expert panel were evaluated by the ASCO Health Services Research Committee reviewers and by the ASCO Board of Directors.

American Society of Clinical Oncology Clinical Practice Guidelines: Opportunities and Challenges

2008 ◽  
Vol 26 (24) ◽  
pp. 4022-4026 ◽  
Author(s):  
Mark R. Somerfield ◽  
Kaitlin Einhaus ◽  
Karen L. Hagerty ◽  
Melissa C. Brouwers ◽  
Jerome Seidenfeld ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Oncology ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Dissemination And Implementation ◽  
Clinical Tools ◽  
American Society ◽  
The Impact

The American Society of Clinical Oncology (ASCO) published its first clinical practice guideline, which focused on the use of hematopoietic colony-stimulating factors, in 1994. Since then, ASCO has published 24 additional guidelines or technology assessments on a range of topics and is developing 11 additional guidelines. Guidelines are among ASCO's most valued products, according to membership surveys and data from the JCO.org Web site. However, the same data from ASCO members have highlighted a number of limitations to the guideline program. These relate to the timelines of guideline updates, difficulties locating guidelines and related products, and challenges to implementing ASCO guidelines in everyday clinical practice. This article outlines the concrete steps that the ASCO Health Services Committee (HSC) is taking to address these limitations, including the institution of a more aggressive guideline updating schedule, a transition from narrative to systematic literature reviews to support the practice recommendations, a new Board of Directors–approved policy to permit endorsement of other groups’ guidelines, and a robust Clinical Tools and Resources program that offers a range of guideline dissemination and implementation aids. Additional work is underway to establish stronger and deeper collaborations with practicing oncologists to expand their role in the review, field testing, and implementation of guideline clinical tools and resources. Finally, the HSC is discussing evaluation of the guidelines program to maximize the impact of ASCO clinical practice guidelines on clinical decision making and, ultimately, the quality of cancer care.

Sign in / Sign up

Export Citation Format

Share Document