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Tumor Markers: The Complete MRCP List (MRCP Part 1)

TL;DR

Tumour markers are a high-yield, frequently tested topic in MRCP Part 1, but questions focus on appropriate use rather than raw memorisation. You are expected to know classic marker–tumour associations, common benign causes of elevation, and when markers are useful for diagnosis, monitoring, or prognosis. This article gives an exam-ready list, common traps, a mini-MCQ, and a practical revision checklist.


Why tumour markers matter in MRCP Part 1

Tumour markers appear deceptively simple, yet they are a consistent source of lost marks. The exam does not test you on using markers as screening tools; instead, it assesses whether you understand their limitations, clinical context, and most appropriate application. Many SBA questions hinge on recognising when a tumour marker is helpful and when it is misleading.

For syllabus context, see the official MRCP Part 1 overview:https://www.mrcpuk.org/mrcpuk-examinations/part-1

You can practise exam-style questions alongside this article using the Crack Medicine Qbank:https://crackmedicine.com/qbank/


Scope of this article

This guide is aligned to the MRCP Part 1 syllabus and focuses on:

  • Core tumour markers you are expected to know

  • The single best use of each marker

  • Benign causes commonly used as distractors

  • Five highly tested subtopics

  • Five classic exam traps


The complete high-yield tumour marker list

Tumour marker

Main malignant association(s)

Important benign causes

Primary exam use

AFP

Hepatocellular carcinoma; non-seminomatous germ cell tumours (yolk sac)

Chronic hepatitis, cirrhosis, pregnancy

Diagnosis & monitoring

β-hCG

Choriocarcinoma; testicular germ cell tumours

Pregnancy

Diagnosis & monitoring

CEA

Colorectal carcinoma

Smoking, inflammatory bowel disease, pancreatitis

Monitoring & recurrence

CA-125

Epithelial ovarian carcinoma

Endometriosis, menstruation, pregnancy

Monitoring response

CA 19-9

Pancreatic adenocarcinoma

Cholestasis, pancreatitis

Monitoring

PSA

Prostate cancer

BPH, prostatitis, ejaculation

Monitoring; contextual screening

Calcitonin

Medullary thyroid carcinoma

C-cell hyperplasia

Diagnosis

Thyroglobulin

Differentiated thyroid cancer

Thyroiditis (context-dependent)

Post-thyroidectomy monitoring

Chromogranin A

Neuroendocrine tumours

Proton-pump inhibitors, renal failure

Diagnosis/monitoring

LDH

Lymphoma; germ cell tumours

Haemolysis, liver disease

Prognosis, tumour burden

β2-microglobulin

Multiple myeloma, lymphoma

Renal impairment

Prognosis

Key principle: tumour markers support diagnosis; they do not replace histology or imaging.


Medical student revising tumour markers for MRCP Part 1 examination

Five most tested subtopics

1. Germ cell tumours

  • AFP + β-hCG + LDH is the classic triad.

  • AFP is not elevated in pure seminoma — a favourite exam trick.

  • LDH correlates with tumour burden and prognosis.

2. Hepatocellular carcinoma (HCC)

  • AFP supports diagnosis in the right context (cirrhosis, hepatitis B/C).

  • AFP alone is not a screening test.

3. Ovarian cancer

  • CA-125 is mainly for monitoring, not screening.

  • Benign gynaecological conditions frequently elevate CA-125.

4. Colorectal cancer

  • CEA is used for post-treatment surveillance and recurrence detection.

  • Smoking is a common cause of false elevation.

5. Thyroid malignancy

  • Calcitonin → medullary thyroid carcinoma.

  • Thyroglobulin is useful only after total thyroidectomy.


Five classic MRCP Part 1 traps

  1. Using tumour markers as population screening tests

  2. Ignoring benign causes of elevation

  3. Assuming a normal marker excludes cancer

  4. Mixing up seminoma and non-seminomatous markers

  5. Forgetting that trends matter more than single values


Mini-MCQ (exam style)

Question: A 62-year-old man undergoes curative resection for sigmoid colon cancer. Which investigation is most appropriate for detecting recurrence during follow-up?

Answer: CEA

Explanation: CEA is not suitable for screening but is useful for monitoring recurrence after curative colorectal cancer treatment. Single values are less useful than serial trends.


Practical revision checklist

Use this weekly during oncology revision:

  • Memorise marker–tumour pairs

  • Add two benign causes to each marker

  • Learn the primary use (diagnosis vs monitoring vs prognosis)

  • Practise trend interpretation

  • Reinforce with timed questions from the Crack Medicine Qbank:https://crackmedicine.com/qbank/

For full-length exam practice, use:https://crackmedicine.com/mock-tests/


FAQs

Are tumour markers used for screening in MRCP Part 1?

Rarely. With limited exceptions (e.g. PSA in context), markers are mainly for monitoring or prognosis.

Can a normal tumour marker rule out cancer?

No. Normal tumour markers do not exclude malignancy.

Which markers are essential for testicular cancer?

AFP, β-hCG and LDH. Remember AFP is not raised in pure seminoma.

Is CA-125 specific for ovarian cancer?

No. It is frequently elevated in benign gynaecological conditions.


Ready to start?

Test recall under exam conditions with a timed set from Start a mock test and revisit weak pairings using the MRCP Part 1 overview.


Sources

 
 
 

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