Daijiworld Media Network – Mumbai

Mumbai, Jul 11: Routine annual tumour marker blood tests are not recommended for healthy adults without symptoms or significant family history, despite growing interest in including them in regular health check-ups for early cancer detection, according to an oncologist.

The clarification comes after a Dubai-based longevity clinic suggested that healthy individuals undergo annual tumour marker tests such as CEA, CA-125, AFP, CA 19-9 and PSA to aid early cancer detection.

Dr Saneya Pandrowala, Consultant, GI and HPB Oncosurgery at KIMS Hospitals, Thane, said current international guidelines do not support the use of these blood tests as a general cancer screening tool because they have not been proven to reduce cancer-related deaths in the general population.

"For most healthy adults with no symptoms or significant family history, routine annual tumour marker testing is not recommended," she said.

Dr Pandrowala explained that evidence-based cancer screening is most effective when it is targeted. She cited mammography for breast cancer, cervical cancer screening and colorectal cancer screening in eligible individuals as examples of proven screening methods.

She noted that tumour markers are primarily used in patients who have already been diagnosed with cancer, where they help monitor response to treatment, detect recurrence or assess disease progression.

Explaining the role of commonly used tumour markers, she said CEA may be elevated in colorectal cancer, CA-125 is associated with ovarian cancer, AFP can increase in liver cancer and certain germ cell tumours, CA 19-9 is linked to pancreatic and biliary cancers, while PSA is associated with prostate disease.

However, she stressed that none of these markers is specific to cancer.

"These markers can also be elevated in many non-cancerous conditions such as infections, inflammation, liver disease, pancreatitis, endometriosis and even smoking in the case of CEA," she said.

She also cautioned that normal tumour marker levels do not rule out cancer.

"Many people with early-stage cancers may have completely normal tumour marker levels. A raised result does not necessarily mean cancer, while a normal result does not rule it out," Dr Pandrowala said.

She warned that indiscriminate use of tumour marker testing could lead to unnecessary anxiety, additional scans and invasive procedures because of false-positive results. Conversely, false reassurance from normal test results could delay diagnosis.

According to Dr Pandrowala, tumour marker testing should always be guided by clinical judgement rather than being included in routine wellness packages.

She said such tests are appropriate for patients with a confirmed cancer diagnosis or when symptoms, physical examination findings or imaging suggest the possibility of a specific malignancy.

Certain high-risk individuals, including those with chronic liver disease, hereditary cancer syndromes or a strong family history of specific cancers, may also benefit from selective tumour marker testing as part of a broader surveillance programme.

Even in such cases, she emphasised that tumour markers should never be interpreted in isolation.

"They are only one piece of the diagnostic puzzle and should always be interpreted alongside clinical evaluation, imaging and other appropriate investigations," she said.

Dr Pandrowala concluded that while tumour marker tests play an important role in cancer management, they are not a substitute for evidence-based cancer screening programmes and should not be used as routine annual screening tests for healthy adults.