Raised tumour marker outside cancer follow-up (CEA, CA 19-9, CA 125, AFP)

Laboratory tests

• AST
• ALT
• GGT
• Serum creatinine with eGFR
• Repeat CEA, in the same laboratory, after at least 1 month without tobacco if possibleif needednon-French guidelineModerate rise in a smoker or with a confounding factor (liver, kidney, poorly controlled diabetes): smoking is an important source of variation in CEA, and one screening centre recommends stopping smoking at least one month before the test ^[1]. The European Group on Tumor Markers (EGTM) asks for any CEA rise to be confirmed on a second sample before investigation, using the same assay method ^[2].

Laboratory tests

• Total and conjugated bilirubin
• GGT
• Alkaline phosphatase
• AST
• ALT
• Fasting plasma glucose
• Serum creatinine with eGFRif needednon-French guidelineKnown or suspected chronic kidney disease: it raises CA 19-9 ^[5].

• No additional routine laboratory test: the examination that matters is pelvic and abdominal ultrasound (see the note).

Laboratory tests

• AST
• ALT
• GGT
• Alkaline phosphatase
• Bilirubin
• Hepatitis B serologyif needednon-French guidelinePeople at risk of hepatocellular carcinoma are those with cirrhosis, notably due to HBV or HCV ^[3].
• Hepatitis C serologyif needednon-French guidelinePeople at risk of hepatocellular carcinoma are those with cirrhosis, notably due to HBV or HCV ^[3].
• Serum β-hCGif needednon-French guidelineYoung man: AFP, hCG and LDH are measured before orchidectomy for the diagnosis of germ cell tumours of the testis ^[13]. Examination of the testes is part of the clinical examination (authors' opinion).
• LDHif needednon-French guidelineYoung man: AFP, hCG and LDH are measured before orchidectomy for the diagnosis of germ cell tumours of the testis ^[13]. Examination of the testes is part of the clinical examination (authors' opinion).