National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers
- Study type
- Clinical guideline
- Study name
- NACB 2008
- Design
- Laboratory medicine practice guideline based on a critical review of published reports
- Source
- Clinical Chemistry · 2008
In plain words
Tumour markers are tests (usually blood tests) that can help in checking for and following up some cancers. This guideline explains which tests are useful, and when, for cancers of the testis, prostate, bowel, breast and ovary. For example, the PSA test is not recommended for prostate cancer screening, but it can be used for follow-up after treatment. These tests should always be interpreted together with the treating doctor.
Key points
Key guideline recommendations
- Level of evidence not stated in the abstract
In testicular cancer, AFP, hCG and LDH are recommended for diagnosis/case finding, staging, prognosis, detection of recurrence and monitoring of therapy. AFP is also recommended for the differential diagnosis of non-seminomatous and seminomatous germ cell tumours.
- Level of evidence not stated in the abstract
PSA is not recommended for prostate cancer screening, but may be used to detect disease recurrence and to monitor therapy.
- Level of evidence not stated in the abstract
Free PSA data are useful for distinguishing malignant from benign prostatic disease when total PSA is below 10 µg/L.
- Level of evidence not stated in the abstract
In colorectal cancer, CEA is recommended (with some limitations) for determining prognosis, postoperative surveillance and monitoring of therapy in advanced disease.
- Level of evidence not stated in the abstract
Faecal occult blood testing may be used for screening asymptomatic adults aged 50 years or older.
- Level of evidence not stated in the abstract
In breast cancer, oestrogen and progesterone receptors are mandatory for predicting response to hormone therapy, and HER2 measurement is mandatory for predicting response to trastuzumab.
- Level of evidence not stated in the abstract
uPA/PAI-1 may be used to determine prognosis in node-negative breast cancer patients. CA15-3/BR27-29 or CEA may be used to monitor therapy in advanced disease.
- Level of evidence not stated in the abstract
CA125 with transvaginal ultrasound is recommended for the early detection of ovarian cancer in high-risk women. CA125 is also recommended for the differential diagnosis of suspicious pelvic masses in postmenopausal women and for detection of recurrence, monitoring of therapy and determination of prognosis in women with ovarian cancer.
Study population
This guideline focuses on the use of tumour markers in five cancer sites: testis, prostate, colorectum, breast and ovary. Details of the search method and study selection criteria are not given in the abstract and are in the full text.
Endpoints
This guideline reviews the clinical uses of tumour markers: diagnosis or case finding, staging, prognosis, detection of recurrence, monitoring of therapy, prediction of response to therapy and screening.
Safety and side effects
According to the abstract, this guideline does not report on adverse effects.
Clinical significance and place in guidelines
This guideline provides a framework for the rational use of tumour markers in five cancer sites and emphasises their use in diagnosis, prognosis, monitoring of therapy and detection of recurrence. Key points include the mandatory use of ER/PR and HER2 in breast cancer and the recommendation against PSA for prostate cancer screening. As this guideline was published in 2008, the current status of the recommendations should be checked against up-to-date guidelines.
Limitations
The abstract gives no information on the level of evidence, the strength of each recommendation or the exact literature search method. This guideline dates from 2008 and may differ from newer guidelines.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.