World Cancer Day – What is the role of laboratory tests in malignant diseases?

World Cancer Day, celebrated every February 4, is a global initiative led by the Union for International Cancer Control (UICC). By raising world awareness, improving education, and catalyzing personal, collective, and governmental action, we all work together to build a world where millions of cancer deaths are saved and access to life-saving treatment and care is equal for all. – no matter who you are or where you live. Thus, the theme of this year’s World Cancer Day, Close the Care Gap, is merely raising awareness of this inequality gap that affects almost everyone, in high- and low- and middle-income countries, and costs lives.

There are currently 19.3 million new cases of cancer in one year worldwide. However, 30-50% of all cancers can be prevented. Reduce your risk of cancer with healthy living habits, regular screening, early detection and timely treatment. The best prevention is regular check-ups, regular check-ups and a visit / consultation with a doctor. Your doctor may recommend that you have several types of blood tests done to get a clearer picture of what is going on in your body.

Tumor markers are substances (proteins, enzymes, hormones, etc.) that are secreted in the body as a result of its response in the presence of a benign or malignant phenomenon. Their measurement and identification is useful in assisting in the diagnosis, as well as in monitoring the progression / course of the disease and the success of therapy. What do the values ​​of the tumor markers indicate? In chemotherapy, hormone and radiation therapy, the movement of marker values ​​in the blood can be used to assess the effectiveness of therapy. If the values ​​decline, it is an indication that there is a response to therapy. Conversely, elevated levels of tumor markers on screening suggest a recurrence of the tumor or metastasis (and they do so up to six months before the X-ray or ultrasound examination), so the treatment strategy should be changed.

There are several types of tumor markers available in the Avicenna Laboratory, depending on which part of the body needs to be screened:

AFP (Alpha – Fetoprotein)

AFP (Alpha – Fetoprotein)
Serum alpha-fetoprotein levels serve as markers for hepatocellular carcinoma and metastatic liver tumor. In addition, this marker is used to assess the risk of fetal defects (eg neural tube defects)

(CA 15-3) (“cancer antigen” – cancer antigen 15-3)

(CA 15-3) (“cancer antigen” – cancer antigen 15-3)
This marker is of great importance in controlling the course of the disease in patients with malignant breast neoplasms. The height of the marker values ​​is largely dependent on the activity of the disease and can be used for differential-diagnostic purposes in diseases of the breast of women. Joint determination of SA 15-3 and SEA detects breast cancer metastasis with 80% certainty.

(CA 19 – 9)

(CA 19 – 9)
This marker is important primarily in tumors of the pancreas and bile ducts. Tumors that can frequently give elevated SA 19-9 values ​​are: pancreatic malignancies, bile duct cancer, gastric and colon cancer.

CA 125

CA 125
CA 125 is primarily relevant as a tumor marker for the detection of malignant ovarian neoplasms. Other diseases that can give elevated levels of SA 125 are: cirrhosis of the liver, acute pancreatitis (inflammation of the pancreas), acute cholecystitis (inflammation of the gallbladder) and other benign gynecological diseases or inflammation.

CA 72-4

CA 72-4
Tumor marker for multiple adenocarcinomas, including gastric cancer. The values ​​of this marker in the serum coincide with the stage of the disease. The more advanced the stage of the disease, the higher the serum values ​​of CA 72-4.

S 100 protein
S – 100 has prognostic value and diagnostic value in patients with malignant melanoma.


CEA (carcino-embryonic antigen)
Nonspecific tumor marker that is determined in combination with specific tumor markers for monitoring and prognosis in patients with various types of cancer, such as colorectal cancer. Determination of SEA values ​​plays an important role in colon cancer, where the height of the values ​​is directly dependent on the stage of the tumor.


PAP (prostatic acid phosphatase) and PSA (prostate specific antigen)
Pap smears, along with PSA, are markers for monitoring prostate cancer patients. For early detection of prostate cancer, in addition to the clinical examination, it is important to determine the markers that will prove the existence of the disease. Total PSA, acid phosphatase, and PAP (prostatic acid phosphatase) are the most important markers for early detection of prostate cancer, in combination with medical examination and other clinical trials.

HE-4 (human epididymis protein 4) and NE-4 + SA-125 (ROMA INDEX)

HE-4 (human epididymis protein 4) and NE-4 + SA-125 (ROMA INDEX)
HE-4 (human epididymis protein 4) is a serum biomarker whose concentration is significantly increased in patients with epithelial ovarian cancer and has a higher sensitivity and specificity than the SA-125 marker. It is used as an aid in diagnosis, as well as monitoring the response to therapy in patients with ovarian cancer. When combined with the SA-125 marker, the sensitivity and specificity of the SA-125 marker itself is greatly increased.
The combination of NE-4 + SA-125 (ROMA INDEX) is a new tool for differential diagnosis in determining whether the tumor mass in the pelvis is benign or malignant in both premenopausal and postmenopausal women and provides risk stratification and direction for further treatment.

What do the results mean?
The test results must be interpreted carefully as several factors can affect the test results.
In addition, keep in mind that non-cancerous conditions can sometimes cause abnormal test results.
Your doctor must review your test results and give you directions for further testing and / or treatment.

Preventive measures

  • Smoking is a proven cause of cancer. Therefore, this is a reason that can be easily influenced
  • Alcohol consumption can also be prevented
  • Weight and obesity – one of the best ways to reduce the risk of cancer, after quitting smoking, is to maintain a healthy weight
  • Physical inactivity – being inactive increases the risk of a number of cancers
  • diet – of all the things in our lifestyle that are related to cancer, our diet is perhaps the most talked about. A balanced diet rich in fiber, fruits and vegetables and low levels of red and processed meats, saturated fats and salt can reduce the risk of cancer
  • UV radiation from the sun and solariums – although we need a small amount of UV to make vitamin D, excessive amounts can cause skin cancer
  • Infections – Although people cannot get cancer from each other, some cancers are caused by infections with viruses and bacteria. Therefore, it is important to look out for protected sex that can prevent the transmission of hepatitis B and C, which can lead to liver cancer; and HPV, which causes several types of cancer, including almost all cases of cervical cancer.