This chapter first provides a high level overview of cancer as a clinical condition. Then the relationship between cancer marker tests and clinical management of cancer patients is reviewed, covering screening, diagnosis, classification, staging and grading, prognosis, and monitoring for recurrence. Some further general information is provided about cancer screening and recent developments in assay technology. There follows extensive coverage of cancer marker tests. For each analyte, the structure and normal function (if applicable) are explained, with the clinical applications of the test and its limitations. Typical assay technology is also described. The type of sample and frequency of use are included, with an example reference interval (for background information only). The analytes included are: carcinoembryonic antigen, alphafetoprotein, carbohydrate antigen 19-9 (sialyl Lewis^A), cancer antigen 125 (MUC16), cancer antigens 15-3 and 27.29 (MUC1), estrogen receptor, progesterone receptor, fecal occult blood, prostate-specific antigen, beta-2-microglobulin, neuron-specific enolase, squamous cell carcinoma antigen, CYFRA 21-1, human chorionic gonadotropin, human epidermal growth factor receptor, bladder tumor antigen and free light chain assays. There is also a section on immunochromatography assays for tumor markers. In the final section minor and experimental tumor markers are covered. These are: cancer antigen 72.4, S-100 antigen, bone alkaline phosphatase, nuclear matrix protein-22, chromagranin A, telomerase, urinary bladder cancer antigen, normetanephrine and metanephrine, promyelocytic leukemia protein, tumor M2 pyruvate kinase, ADAM8, HE4, PSME3, Arf, Ki67, vascular epidermal growth factor, cyclin E, TBX2, TBX3, TA-90, K-ras and CA72.4.

Hoon Sunwoo is currently Associate Professor in the Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta. His major specialization includes translational immunology and biotechnology research for Diagnostics, Therapeutics and Vaccines based on engineered antibody technologies. Research Area 1 - Diagnostics: Development of cost-effective and rapid Point-of-Care diagnostics against viruses by bispecific monoclonal antibodies and genetic markers by LAMP assay. Research Area 2 - Therapeutics: Recombinant strategies based on bacteria for cancer therapy, and using IgY anti-gluten antibodies as oral passive immunotherapy for autoimmune celiac disease. Research Area 3 - Vaccines: Dendritic cell targeted vaccines based on engineered antibody for use in human and livestock, and IgY antibody as veterinary biologic to prevent chicken osteoporosis. He has published 45 Refereed Journals, 3 patents, 2 books, 15 book chapters, and 18 Proceedings.

This chapter also contains material contributed to previous editions of The Immunoassay Handbook by Dr Mavanur R. Suresh, Professor, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Canada.

Cancer, cancer marker, tumor, tumor marker, benign, malignant, metastasis, carcinoma, sarcoma, Bence-Jones protein, screening, prognosis, recurrence, lung cancer, liver cancer, breast cancer, stomach cancer, prostate cancer, colorectal cancer, pancreatic cancer, ovarian cancer, testicular cancer, cervical cancer, bladder cancer, marrow cancer, brain tumor, glycoprotein, carcinoembryonic antigen, alphafetoprotein, carbohydrate antigen 19-9, sialyl Lewis^A, cancer antigen 125, MUC16, cancer antigen 15-3, cancer antigen 27.29, MUC1, estrogen receptor, progesterone receptor, fecal occult blood, prostate-specific antigen, beta-2-microglobulin, neuron-specific enolase, squamous cell carcinoma antigen, CYFRA 21-1, human chorionic gonadotropin, human epidermal growth factor receptor, bladder tumor antigen, free light chain assay, cancer antigen 72.4, S-100 antigen, bone alkaline phosphatase, nuclear matrix protein-22, chromagranin A, telomerase, urinary bladder cancer antigen, normetanephrine, metanephrine, promyelocytic leukemia protein, tumor M2 pyruvate kinase, ADAM8, HE4, PSME3, Arf, Ki67, vascular epidermal growth factor, cyclin E, TBX2, TBX3, TA-90, K-ras, CA72.4.

The American Association for Clinical Chemistry has a useful website, mainly targeted at the public, on tumor markers at http://labtestsonline.org/understanding/analytes/tumor-markers/. The table of tumor markers is updated regularly.

The National Cancer Institute in the US also provides comprehensive information on tumor markers at www.cancer.gov/cancertopics/factsheet/detection/tumor-markers.