Tumormarker zur Früherkennung – sinnvoll oder sinnlos?

Abstract

Screening programs for early detection of cancer aim to reduce mortality and mobidity. Therefore, effective therapy for early stages of the respective disease should be available. Tumor markers are not established tools for screening of healthy populations since they lack sensitivity and specificity in detecting diseases. Nevertheless, screening with tumor markers would be an attractive tool since side effects of other screening modalities (radiation endoscopy etc) are avoided. To implement tumor markers in screening programs, markers or marker profiles with higher sensitivity and specificity are needed. Novel tumor markers may include microRNA, antibodies directed against tumor-specific antigens, cell-free DNA as well as circulating exosomes. Tumor markers may already be used in some follow-up care settings to detect recurrences at an early stage.

Attitudes and health behaviors of middle-aged and older adults with elevated tumor markers in China

“…On the one hand, TMs test is a convenient approach for cancer screening. Tumor cells generate some molecules into circulation and higher levels can be detected so that these molecules are given the name of “TM.” Cause TMs can be indicative of corresponding tumors ( Modest and Heinemann, 2015 ) and need only simple blood-tests, TMs are widely applied for early-diagnosis, staging, prognosis, detecting recurrence, and monitoring therapy for cancer ( Sturgeon, 2002 ). For example, measuring prostate-specific antigen (PSA) as a screening parameter in AHEs was useful to detect prostate cancer early with a detection rate of 2.1% in males older than 50 years ( Uchida et al, 2000 ).…”

“…However, TMs tests are not recommended in the screening of a healthy population because of their unsatisfactory sensitivity and specificity ( Sturgeon, 2002 ; Modest and Heinemann, 2015 ). According to a large health checkup cohort study, the percentage of general population with elevated carbohydrate antigen 19–9 (CA 19–9) was approximately 1% and only 0.04% were diagnosed with cancer, implying that the application of CA 19–9 test for cancer screening in the healthy population was inappropriate ( Wang et al, 2016 ; Lee et al, 2019 ).…”