use of tumor markers in testicular, prostate, colorectal, breast, and ...

Chapter 1
Introduction
We present to clinical chemists, clinicians, and other practitioners
of laboratory and clinical medicine the latest update of the
National Academy of Clinical Biochemistry (NACB) Laboratory
Medicine Practice Guidelines (LPMG) for the use of tumor
markers in testicular, prostate, colorectal, breast, and ovarian
cancers. These guidelines are intended to encourage more appropriate
use of tumor marker tests by primary care physicians,
hospital physicians and surgeons, specialist oncologists, and
other health professionals.
Clinical practice guidelines are systematically developed
statements to assist practitioners and patients to make decisions
about appropriate health care for specific clinical circumstances
(1). An explanation of the methodology used when developing
these Guidelines appears in the introduction of the Tumor
Markers: Quality Requirements LMPG, which can be found on
1
the NACB web site (2) and as an Appendix to this document.
As might be expected, many of the NACB recommendations
are similar to those made by other groups, as is made clear from
the tabular comparisons presented for each malignancy (2). In
order to prepare these guidelines, the literature relevant to the
use of tumor markers was reviewed. Particular attention was
given to reviews including the few relevant systematic reviews
and to guidelines issued by expert panels. Where possible, these
consensus recommendations of the NACB panels were evidence
based. The Tumor Markers: Quality Requirements LMPG presents
NACB recommendations relating to general quality
requirements for tumor measurements, and includes tabulation
of important causes of false positive tumor marker results (eg,
due to heterophilic antibody interference, “high dose hooking”)
which must also be taken into account (3).