I READ with interest the article Making sense of your blood test (FitForLife, StarMag, April 11, 2004). As a doctor, I have the following comments. Although Diong Swee Hoon correctly made a distinction between “screening” and “diagnostic” tests, the lay public and some commercial medical laboratory tend to use serum tumour markers as screening tests.
Recently a commercial medical laboratory has been offering the general public the use of the serum tumour marker CA 19-9 as a screening tool of stomach cancer. This practice is rather disturbing as the evidence for the effectiveness of this screening tool is tenuous. CA 19-9 is not specific, meaning it can come from sources other than stomach cancer cells. CA 19-9 does not discriminate between bile duct cancer, pancreatic cancer or stomach cancer and may also be raised in severe liver injury from any cause (consensus document by the British Society of Gastroenterology, Nov 2002, vol 51, suppl VI).
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