Optional tests

Top 5 optional tests popular among men

Top 5 optional tests popular among women

Test items

Lung cancerCEA, CYFRA, and NSE (3 types)

These tests measure blood levels of substances that increase in the presence of lung cancer: CEA (carcinoembryonic antigen) for the adenocarcinoma type, CYFRA 21-1 for the squamous cell carcinoma type, and NSE (neuron specific enolase) for the small-cell cancer type.
However, the accuracy of tumor markers is not that high.
In particular, in early-stage lung cancer, many patients test negative for tumor markers, and a certain percentage of patients who do not have lung cancer receive “false-positive” results.
For this reason, tumor marker testing is currently used more as an aid to gauge cancer cell disappearance after treatment or check for cancer recurrence than as a screening test for lung cancer.

Esophageal cancerCEA, SCC antigen, and CYFRA (3 types)

More than 90% of Japanese patients with esophageal cancer have squamous cell carcinoma.
These tumor markers are often used because the blood levels of the substance “CEA” or “SCC” increase when squamous cell carcinoma develops in the body.
In the “adenocarcinoma” type of cancer, which is common among Europeans and Americans, it is “CEA” that increases.
However, the accuracy of tumor markers is not necessarily high, and abnormal values may not be exhibited in the early stages of cancer.

Stomach cancer and colon cancerCEA and CA19-9 (2 types)

“CEA” is the most common tumor marker. Increased levels of this tumor marker are observed not only in gastrointestinal cancers (colon cancer, stomach cancer, etc.) but also in breast cancers and others.
For this reason, it is difficult to identify a cancer simply on the basis of a high level of “CEA.”
The positive rate for colon cancer is about 50%.
“CA19-9” is detected frequently and at high levels in patients with pancreatic cancer and advanced gastrointestinal tumors (advanced stomach cancer or colon cancer), etc.

Pancreatic cancer/biliary tract cancerCA19-9, DUPAN-2, Span-1, elastase 1 (4 types)

“CA19-9” is an excellent tumor marker that is detected frequently and at high levels in patients with pancreatic cancer and advanced gastrointestinal tumors (advanced stomach cancer or colon cancer), etc.
Characteristically, the positive rate for tumor marker “DUPAN-2” is high among patients with pancreatic cancer, gallbladder cancer, bile duct cancer, and liver cancer but low among patients with gastrointestinal cancers such as esophageal cancer, stomach cancer, and colon cancer.
When pancreatic cancer is suspected, this tumor marker is useful in differentiating between malignancies and benign disease, as well as in postoperative/post-treatment follow-up because it is low in most cases of chronic pancreatitis or acute pancreatitis.
「Span-For “Span-1,”the rate of false positives observed with benign disease is extremely low, and even when there is a false-positive result in a case of acute pancreatitis that is difficult to differentiate from pancreatic cancer, this tumor marker will often be elevated only to a slight extent. Therefore, it is considered a useful indicator for more specific cancer diagnosis and postoperative/post-treatment follow-up.
In pancreatic cancer, abnormally high levels of elastase 1 are observed, reflecting pancreatitis associated with pancreatic duct obstruction caused by the tumor.

Liver cancerAFP, PIVKA-II (2 types)

This test is very sensitive for liver cancer.
In particular, the higher the tumor size, the higher the positive rate.
Testing for both “AFP” and “PIVKA-II” increases the accuracy of diagnosis.

Breast cancerCEA, CA15-3, and BCA225 (3 types)

High levels of “CEA” are observed in not only breast cancer but also in gastrointestinal cancers, etc.
High levels of “CA15-3” are observed in breast cancer, ovarian cancer, and uterine cancer, etc.
High levels of “BCA225” are observed in breast cancer.
Even if a high level of a tumor marker is found by a test, it only means that cancer is suspected. In order to confirm that cancer is present, it is necessary to perform imaging tests in parallel with the tumor marker tests.

Ovarian cancerCA125 (1 type)

This marker is basic to the diagnosis of ovarian cancer.
It also reacts sensitively to endometriosis and adenomyosis of the uterus.
Therefore, “CA125” is used as a criterion in screening tests, follow-up observation, and treatment response evaluation for these diseases.
CA125 may also be elevated in lung cancer, liver cancer, biliary tract cancer, colon cancer, breast cancer, uterine cancer, ovarian tumor, and others. It can even be elevated during menstruation in healthy people.

Uterine cancerCEA, CA125, and SCC antigen (3 types)

“CA125” is a tumor marker that shows specific responses to ovarian cancer and uterine cancer.
Since both the positive rate and the measured value increase as the cancer progresses, it is also important as a means of assessing the therapeutic effect and predicting recurrence.
However, it may also be elevated in many other cancers besides ovarian cancer.

Prostate cancerHigh-sensitivity PSA (1 type)

PSA is prostate specific, and if an abnormal test value is obtained, we can find prostate cancer very efficiently.
However, because it is too sensitive, it may also detect prostate cancer that does not require treatment.
A high PSA level may also be observed in patients with prostatic hyperplasia or prostate inflammation.