title: National Academy of Clinical Biochemistry laboratory medicine practice guidelines for use of tumor markers in testicular, prostate, colorectal, breast, and ovarian cancers.
abstract: BACKGROUND
  Updated National Academy of Clinical Biochemistry (NACB) Laboratory Medicine Practice Guidelines for the use of tumor markers in the clinic have been developed.
  
  
  METHODS
  Published reports relevant to use of tumor markers for 5 cancer sites--testicular, prostate, colorectal, breast, and ovarian--were critically reviewed.
  
  
  RESULTS
  For testicular cancer, alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase are recommended for diagnosis/case finding, staging, prognosis determination, recurrence detection, and therapy monitoring. alpha-Fetoprotein is also recommended for differential diagnosis of nonseminomatous and seminomatous germ cell tumors. Prostate-specific antigen (PSA) is not recommended for prostate cancer screening, but may be used for detecting disease recurrence and monitoring therapy. Free PSA measurement data are useful for distinguishing malignant from benign prostatic disease when total PSA is <10 microg/L. In colorectal cancer, carcinoembryonic antigen is recommended (with some caveats) for prognosis determination, postoperative surveillance, and therapy monitoring in advanced disease. Fecal occult blood testing may be used for screening asymptomatic adults 50 years or older. For breast cancer, estrogen and progesterone receptors are mandatory for predicting response to hormone therapy, human epidermal growth factor receptor-2 measurement is mandatory for predicting response to trastuzumab, and urokinase plasminogen activator/plasminogen activator inhibitor 1 may be used for determining prognosis in lymph node-negative patients. CA15-3/BR27-29 or carcinoembryonic antigen may be used for therapy monitoring in advanced disease. CA125 is recommended (with transvaginal ultrasound) for early detection of ovarian cancer in women at high risk for this disease. CA125 is also recommended for differential diagnosis of suspicious pelvic masses in postmenopausal women, as well as for detection of recurrence, monitoring of therapy, and determination of prognosis in women with ovarian cancer.
  
  
  CONCLUSIONS
  Implementation of these recommendations should encourage optimal use of tumor markers.
authors.affiliation: Department of Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, UK. c.sturgeon@ed.ac.uk
authors.forename: Catharine M
authors.initials: CM
authors.lastname: Sturgeon
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Duffy
authors.forename: Ulf-Håkan
authors.initials: UH
authors.lastname: Stenman
authors.forename: Hans
authors.initials: H
authors.lastname: Lilja
authors.forename: Nils
authors.initials: N
authors.lastname: Brünner
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Chan
authors.forename: Richard
authors.initials: R
authors.lastname: Babaian
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bast
authors.forename: Barry
authors.initials: B
authors.lastname: Dowell
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Esteva
authors.forename: Caj
authors.initials: C
authors.lastname: Haglund
authors.forename: Nadia
authors.initials: N
authors.lastname: Harbeck
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hayes
authors.forename: Mads
authors.initials: M
authors.lastname: Holten-Andersen
authors.forename: George G
authors.initials: GG
authors.lastname: Klee
authors.forename: Rolf
authors.initials: R
authors.lastname: Lamerz
authors.forename: Leendert H
authors.initials: LH
authors.lastname: Looijenga
authors.forename: Rafael
authors.initials: R
authors.lastname: Molina
authors.forename: Hans Jørgen
authors.initials: HJ
authors.lastname: Nielsen
authors.forename: Harry
authors.initials: H
authors.lastname: Rittenhouse
authors.forename: Axel
authors.initials: A
authors.lastname: Semjonow
authors.forename: Ie-Ming
authors.initials: IeM
authors.lastname: Shih
authors.forename: Paul
authors.initials: P
authors.lastname: Sibley
authors.forename: György
authors.initials: G
authors.lastname: Sölétormos
authors.forename: Carsten
authors.initials: C
authors.lastname: Stephan
authors.forename: Lori
authors.initials: L
authors.lastname: Sokoll
authors.forename: Barry R
authors.initials: BR
authors.lastname: Hoffman
authors.forename: Eleftherios P
authors.initials: EP
authors.lastname: Diamandis
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000175:diagnosis*; D019411:Clinical Laboratory Techniques / Q000592:standards; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012016:Reference Values; D013736:Testicular Neoplasms / Q000175:diagnosis*
chemical_list: D014408:Biomarkers, Tumor