In the past, cervical cancer was one of the most common causes of death in the United States. Advances in screening and treatment led to a
Tumor marker testing is one of the ways treatment is improving. Tumor markers are indicators of cancer in the blood. They can help doctors or healthcare professionals see how your body is responding to cervical cancer and can help them determine how aggressive the cancer is. This allows them to craft a treatment plan that can lead to the best outcome.
While doctors don’t typically use tumor markers as part of screening, research shows tumor marker testing could be helpful in tracking treatment and predicting outlook for people with cancer. This article will discuss which tumor markers might suggest cervical cancer, how doctors might interpret test results, and the limitations of those results.
A tumor marker is a protein, genetic fragment, or other substance that indicates the presence of a tumor. In some people, their cancer cells make the tumor marker. In other people, their body may make the marker in response to the cancer cells.
During diagnosis, these markers can give doctors information about how aggressive your cancer is and what type of treatment might work best. Tracking these markers over time can also help a doctor see how well you’re responding to treatment.
Some tumor markers are associated with one specific type of cancer. Others are associated with multiple types of cancer.
But there are limitations to tumor markers.
Not all types of cancer have known tumor markers. Additionally, not everyone with cancers with known markers will show those markers. There are also conditions that can cause false positives for many tumor markers.
For these reasons, tumor markers are only one piece of the diagnostic process.
Various studies have identified different tumor markers that commonly appear with cervical cancer. These markers typically aren’t exclusive to cervical cancer but can help doctors during the diagnostic process.
There are two subtypes of cervical cancer: squamous cell carcinoma (SCC) and adenocarcinoma. Some markers may also indicate your subtype of cervical cancer.
Common tumor markers for cervical cancer include:
- cancer antigen 125 (CA 125)
- carcinoembryonic antigen (CEA)
- cancer antigen 19-9 (CA 19-9)
- SCC antigen (SCCA)
- cytokeratin 19 fragment antigen 21-1 (CYFRA 21-1)
Cancer antigen 125 (CA 125)
CA 125 is a glycoprotein (a protein with carbohydrate groups) normally found in your blood. When it’s present in higher amounts, it can indicate certain cancers, including:
But some gynecological and liver conditions can also increase your CA 125 levels.
Carcinoembryonic antigen (CEA)
CEA is a glycoprotein used for womb development. Adults typically carry it in trace amounts, but high levels can indicate the following cancers:
Smoking, stomach ulcers, and a range of other less serious health conditions can also cause raised CEA levels.
Cancer antigen 19-9 (CA 19-9)
You may regularly have small amounts of the glycoprotein CA 19-9 in your blood. But elevated levels could be a sign of the following cancers:
- pancreatic
- bile duct
- colon or colorectal
- stomach
According to a 2018 review, some people with cervical cancer have elevated CA 19-9 levels when they don’t have elevated CA 125 levels.
Elevated CA 19-9 levels could also be due to cirrhosis or gallstones. But according to
Squamous cell carcinoma antigen (SCCA)
SCCA is an antigen present in the SCC subtype of cervical cancer. That accounts for about 80% of all people with cervical cancer. In addition to cervical cancer, it
Doctors typically use its levels to determine how well treatment is going or to see if your cancer has recurred. According to
Cytokeratin 19 fragment antigen 21-1 (CYFRA 21-1)
CYFRA 21-1 is a protein fragment found in several cancers,
- lung
- gastrointestinal
- cervical
- head and neck
Elevated levels of CYFRA 21-1 may suggest the SCC subtype of cervical cancer. According to research, if your levels are high after treatment, it may mean that there’s residual cancer. But low levels don’t necessarily mean that your cancer is gone.
The same research also suggests that higher CYFRA 21-1 levels are associated with more advanced stages of cervical cancer.
Other markers
There are other markers that doctors often use to find gynecological cancers, including ovarian and uterine cancer. For some, their role in cervical cancer remains unclear. They include:
- alpha-fetoprotein
- beta human chorionic gonadotropin
- cancer antigen 15-3
- inhibin A
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Are tumor markers used in screening?
Doctors don’t currently use tumor markers as part of screening. Researchers hope that in the future, it might be possible to use tumor markers predictively, but it’s not possible right now.
Tumor markers can provide a wealth of important information, but they aren’t an exact tool. Tumor markers don’t find everyone with cancer or even everyone with very specific types of cancer.
Tumor markers as part of screening can also lead to overdiagnosis. Elevated marker levels can be due to several other causes. Tumor marker levels can also change over time, making them too unreliable to use in screening.
Tumor marker test results on their own can’t confirm cervical cancer. A doctor will likely order several other tests to confirm a diagnosis.
But your tumor marker test results can indicate how aggressive your cancer is. Higher numbers can indicate your cancer is spreading. If you’re currently in treatment, elevated levels could signal a recurrence of cancer or the need for more intense therapy.
The following are
| Tumor marker | Elevated result |
| CA 125 | more than 35 units/mL |
| CEA | more than 5 ng/mL |
| CA 19-9 | more than 39 units/mL |
| SCCA | more than 1.5 ng/mL |
| CYFRA 21-1 | more than 3.3. ng/mL |
Remember that elevated levels don’t mean that you have cancer or that your cancer has returned. They may just be a sign for a doctor to follow up or run more tests. A doctor will review your test results with you.
Doctors perform a tumor marker test with a standard blood draw or urine sample. Often, you’ll do both at once so they can run multiple tests.
Your healthcare team will send your blood and urine to a lab for analysis. A doctor will contact you with the results in a few days.
A tumor marker test is one optional part of the diagnostic process for cervical cancer. A doctor will order several tests to confirm a diagnosis. Your tumor marker test results could help confirm that diagnosis, but they’re not enough on their own to diagnose cancer.
Your results could lead a doctor to request additional testing. For instance, you might have imaging tests or a biopsy. If your other tests have confirmed cervical cancer, your tumor marker test results could help a doctor determine your treatment plan.
Testing for tumor markers may be part of your treatment plan. Several months after treatment, a doctor may test again for the same tumor markers. Based on the new test results, they’ll discuss with you how your treatment is working and how they plan to move forward.
Questions for a doctor
It’s important to understand the reasons for your tumor marker test and the results. Asking a doctor questions can help you get the information you need. Here are some questions you can ask to learn more:
- Why am I having these tests?
- Which tumor markers are you looking for?
- Why do you think I might have those tumor markers?
- What are my tumor marker levels?
- What do my results mean?
- Will I need to have this test again?
- How often will I need to have this test?
- Do these results affect my treatment plan?
- What might be causing my elevated tumor marker levels?
- What are the next steps?
Tumor markers are indicators of cancer that doctors can see in your blood. These indicators include proteins, genetic material, and other substances. They derive from either a cancer tumor or your body’s response to a tumor.
Assessing the levels of these markers can help doctors understand the type of cancer you have, how aggressive the cancer is, and how your body is responding to treatment.
There are several tumor markers for cervical cancer. None are exclusive to cervical cancer or able to provide a definitive diagnosis. Still, their presence provides information doctors can use to stage your cancer and create an effective treatment plan.