Tumor Markers in Primary Care: When to Order, When to Step Away, and Why Screening Causes More Harm Than Good
Tumor Markers in Primary Care: When to Order, When to Step Away, and Why Screening Causes More Harm Than Good PSA, CA-125, CEA, AFP—the tests that cause the most unnecessary panic in your practice. Tumor markers are among the most misused tests in primary care. They get ordered for vague abdominal pain, pelvic discomfort, fatigue, or "just to be thorough"—and then a mildly elevated result triggers imaging, referrals, biopsies, and patient anxiety for a condition that doesn't exist. The core principle: tumor markers are for monitoring known cancers, not for screening asymptomatic patients (with limited exceptions). The Markers: What They Do and Don't Tell You Marker Primary Cancer Association Non-Cancer Causes of Elevation Role in Primary Care PSA Prostate cancer BPH, prostatitis, recent ejaculation, bike riding, UTI, age Screening (shared decision-making for men 55–69); monitoring after treatment CA-125 Ovarian cancer Endometriosis, fibroids, PID, pregnancy, menst...