Abstract
A total of 73,443 asymptomatic individuals were screened on a voluntary basis for cancer at Chang Gung Memorial Hospital in Taiwan using a panel of tumor markers, including alpha fetoprotein (AFP), CA 125, CA 15‐3, CA 19‐9, carcinoembryonic antigen (CEA), prostate specific antigen (PSA), chromogranin A (CgA), and squamous cell specific antigen (SCC). The results are derived from data collected from January 1998 to October 2003. A total of 210 cancers (approximately 0.3%) were detected, including cancers of the liver, lung, colon, prostate, stomach, pancreas, breast, cervix, ovary, and bladder. Of the tumor markers monitored, elevated CA 19‐9, CEA, and CA 125 were the most frequently detected in a variety of cancers. It was surprising to find that many cancers were not detected by their dominant markers but by the elevation of tumor markers not recommended for monitoring their tumor activity. Screening with multiple circulating tumor markers provides improved sensitivity for cancer detection in asymptomatic individuals before they reach the fatal advanced stage. Screening with multiple tumor markers also allows cancers to be detected in the absence of their dominant markers. If we had not measured the multiple tumor markers, these cancers would have gone undetected. J. Clin. Lab. Anal. 20:42–46, 2006. © 2006 Wiley‐Liss, Inc.
Keywords: asymptomatic population, Chinese, carcinoma, multiple tumor markers
Abbreviations | |
---|---|
AFP | alpha‐fetoprotein |
ca | carcinoma |
CEA | carcinoembryonic antigen |
CgA | chromogranin A |
PSA | prostate specific antigen |
tPSA | free PSA+PSA‐ACT complex |
SCC | squamous cell carcinoma antigen |
NPC | nasopharyngeal carcinoma |
REFERENCES
- 1. Wu JT, Nakamura R. Human circulating tumor markers. Current concepts and clinical applications. Chicago: American Society of Clinical Pathologists Press, 1997. [Google Scholar]
- 2. Catalona W, Smith DS, Ratliff TL, et al. Measurement of prostate‐specific antigen in serum as a screening test for prostate cancer. N Engl J Med 1991:324;1156–1161. [DOI] [PubMed] [Google Scholar]
- 3. Wu JT. Expression of monoclonal antibody‐defined tumor markers in four carcinomas. Ann Clin Lab Sci 1989;19:17–26 [PubMed] [Google Scholar]
- 4. Wu T‐L, Chang CP‐Y, Tsao K‐C, Sun C‐F, Wu JT. Development of a microplate assay for serum chromogranin A (CgA): establishment of normal reference values and the detection of elevated CgA in carcinomas. J Clin Lab Anal 1999;13:312–319. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5. Wu JT, Astill ME, Liu GH, Stephenson RA. Serum chromogranin A: early detection of hormonal resistance in prostate cancer patients. J Clin Lab Anal 1998;12:20–25. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6. Wu JT, Erickson AJ, Tsao K‐C, Wu T‐L, Sun C‐F. Elevated serum CgA is detectable in carcinomas at advanced stage. Ann Clin Lab Sci 2000;30:175–178. [PubMed] [Google Scholar]
- 7. Schwartz LM, Woloshin S, Fowler FJ Jr, Welch HG. Enthusiasm for cancer screening in the United States. JAMA 2004;291:71–78. [DOI] [PubMed] [Google Scholar]
- 8. van Haaften‐Day C, Shen Y, Xu F, et al. OVX1, macrophage‐colony stimulating factor, and CA‐125‐II as tumor markers for epithelial ovarian carcinoma: a critical appraisal. Cancer 2001;92:2837–2844. [DOI] [PubMed] [Google Scholar]
- 9. Fehm T, Beck E, Valerius T, Gramatzki M, Jager W. CA 125 elevations in patients with malignant lymphomas. Tumour Biol 1998;19:283–289. [DOI] [PubMed] [Google Scholar]
- 10. Moody MD, Van Arsdell SW, Murphy KP, Orencole SF, Burns C. Array‐based ELISAs for high‐throughput analysis of human cytokines. Biotechniques 2001;31:186–194. [DOI] [PubMed] [Google Scholar]
- 11. Wiese R, Belosludtsev Y, Powdrill T, Thompson P, Hogan M. Simultaneous multianalyte ELISA performed on a microarray platform. Clin Chem 2001;47:1451–1457. [PubMed] [Google Scholar]