Don’t routinely prescribe serum cancer markers during the diagnostic or staging procedures in cancer care.

Type of practice

Laboratory tests

Topic Area

Medical Oncology

The serum tumor markers are often required in an appropriate way as they need a simple blood sample. Given the high cost of each prescription tests and the high number of required tests it represents a considerable employment of resources; in addition it represents a source of anxiety for the patient in the case of a false positive result. Their inappropriate use in asymptomatic patients, in the presence of a test higher than normal, often require further diagnostic tests and medical and surgical inappropriate treatments. In diagnostic setting these markers can be considered only in well-defined types of malignancies, not particularly frequent (hepatocellular carcinoma, testicular tumors, pancreatic cancer). Tumour markers may be indicated only as therapy monitoring and follow-up of patients with ascertained diagnosis of neoplasia, only in the cases that are established by specific guidelines.


1. Guida all’uso clinico dei biomarcatori in Oncologia 2010”: Gion M, Trevison C, Pregno S, Aline S.C. F; Edizioni Biomedia.
2- Deliberazione Regione Liguria N. 1347 del 11/11/2011 “Indicazioni per la limitazione dell’uso diagnostico di alcuni biomarcatori tumorali.
3. NCCN Suppl, Vol 9 Suppl 5, version November 2011, NCCN Task Force report: evaluating the clinical utility of tumor markers in oncology.

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