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1 Department of Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW, United Kingdom. Fax 44-131-536-2765; e-mail C.Sturgeon{at}ed.ac.uk.
Background: Increasing interest in implementing the practice of evidence-based medicine in oncology has encouraged the development of clinical guidelines, many of which include recommendations about the appropriate use of serum tumor markers.
Methods: Recent national and international guidelines relating to the use of tumor markers in germ cell, colorectal, breast, ovarian, prostate, lung, neuroendocrine, and thyroid cancers were identified from the scientific literature and other sources and tabulated.
Results: Guideline recommendations developed by national and international groups and relating to the use of tumor markers for specific cancers are reviewed and compared, considering the recommendations made for their use in screening, diagnosis, prognosis, and monitoring of therapy. Potential advantages and disadvantages of clinical guidelines, how best to implement them, and means of auditing their effectiveness are also considered.
Conclusions: Excellent clinical guidelines, including recommendations for the most appropriate use of tumor markers, are already available for many cancers. Many questions relating to optimal use of these important tests remain to be answered, but current guidelines already contain much valuable information and advice. Further dissemination and implementation of the guidelines should encourage better use of tumor markers in clinical practice. Careful audit studies are also required to establish the impact of these guidelines on the practice of evidence-based medicine.
The following articles in journals at HighWire Press have cited this article:
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  E. S Kilpatrick and M. J Lind Appropriate requesting of serum tumour markers BMJ, September 22, 2009; 339(sep22_1): b3111 - b3111. [Full Text]
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C M Sturgeon, L C Lai, and M J Duffy Serum tumour markers: how to order and interpret them BMJ, September 22, 2009; 339(sep22_1): b3527 - b3527. [Full Text]
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 R. Franceschini, C. Trevisiol, R. Dittadi, and M. Gion Tumour markers requesting pattern with regards to different organizational settings in Italy: a survey of hospital laboratories Ann Clin Biochem, July 1, 2009; 46(4): 316 - 321. [Abstract] [Full Text] [PDF]
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 C. M. Sturgeon, M. J. Duffy, U.-H. Stenman, H. Lilja, N. Brunner, D. W. Chan, R. Babaian, R. C. Bast Jr., B. Dowell, F. J. Esteva, et al. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers Clin. Chem., December 1, 2008; 54(12): e11 - e79. [Abstract] [Full Text] [PDF]
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E. P. Diamandis, B. R. Hoffman, and C. M. Sturgeon National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for the Use of Tumor Markers Clin. Chem., November 1, 2008; 54(11): 1935 - 1939. [Full Text] [PDF]
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G. Cattozzo, E. Guerra, F. Ceriotti, C. Franzini, and on behalf of the Enzyme Working Group of the Itali Commutable Calibrator with Value Assigned by the IFCC Reference Procedure to Harmonize Serum Lactate Dehydrogenase Activity Results Measured by 2 Different Methods Clin. Chem., August 1, 2008; 54(8): 1349 - 1355. [Abstract] [Full Text] [PDF]
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Z. Cao and R. Rej Are Laboratories Reporting Serum Quantitative hCG Results Correctly? Clin. Chem., April 1, 2008; 54(4): 761 - 764. [Abstract] [Full Text] [PDF]
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G. Soletormos, A. Semjonow, P. E.C. Sibley, R. Lamerz, P. H. Petersen, W. Albrecht, P. Bialk, M. Gion, F. Junker, H.-P. Schmid, et al. Biological Variation of Total Prostate-Specific Antigen: A Survey of Published Estimates and Consequences for Clinical Practice Clin. Chem., August 1, 2005; 51(8): 1342 - 1351. [Abstract] [Full Text] [PDF]
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R. Rej Clinical Chemistry through Clinical Chemistry: A Journal Timeline Clin. Chem., December 1, 2004; 50(12): 2415 - 2458. [Abstract] [Full Text] [PDF]
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 Session 2: Molecular Diagnostics: Molecular Diagnostics: Chairman's Introduction JOHN F. LECHNER, Office of Technology for Diagnostics Systems, Bayer Diagnostics, Berkeley, California 94702 Toxicol Pathol, January 1, 2004; 32(1): 137 - 138. [PDF]
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E. Floyd and T. M. Mcshane Development and Use of Biomarkers in Oncology Drug Development Toxicol Pathol, January 1, 2004; 32(1_suppl): 106 - 115. [Abstract] [PDF]
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