Tumour markers in a MOT

Your Health MOT report arrives, and halfway down there's a line marked CEA, PSA or CA-125, with a number beside it. Perhaps it's flagged. Perhaps it isn't, and you're wondering what that tells you.

A tumour marker in a Health MOT is a blood protein that some cancers can raise, and that ordinary tissue can raise as well. It's a clue for the doctor, read with your examination and imaging, and on its own it can't screen for, diagnose or rule out cancer. If your wider question is whether any blood test can find cancer, start with whether a blood test can detect cancer. This guide covers the markers on Elite and Ultimate.

If you already know you want markers with the pictures beside them, the Elite Health MOT is £1,850 for men and £2,095 for women. The Health Screening Clinic has read these numbers at 117a Harley Street since 1984 and is CQC registered. Every MOT includes a GP consultation, an examination and a review.

Why do tumour markers move?

People add markers because a number feels like proof. Reference ranges are statistical intervals, though, and plenty of everyday things shift a marker: inflammation, smoking, liver disease, menstruation, an enlarged prostate, a benign ovarian cyst or a recent illness. Early disease, meanwhile, can leave the same marker inside range.

That double weakness is why the UK National Screening Committee has not recommended a national programme that uses a general cancer blood test. It's also why NICE suspected-cancer guidance (NG12) uses PSA and CA125 for people with symptoms, instead of offering them to everyone. On our menu, markers arrive at Elite, together with the pictures they need.

What does Elite include?

Elite takes 2.5 to 3 hours, with a minimum four-hour fast. Women's Elite runs on our Thursday and Friday specialist days, and men's Elite is available Monday to Friday.

Women have CEA and CA-125, alongside consultant gynaecology, trans-vaginal and pelvic ultrasound, a smear and a mammogram from age 40. Men have CEA and, from age 40, PSA, alongside abdominal, pelvic and testicular ultrasound.

CEA

CEA is carcinoembryonic antigen. It's mainly used to watch for recurrence in people already known to have bowel cancer. Smoking, inflammatory bowel disease, liver disease and other adenocarcinomas can lift it. Early bowel cancer often leaves it ordinary, which is why the NHS bowel programme uses a stool FIT kit. On Elite, a raised CEA prompts the doctor who examined you to look at the rest of the panel, your abdomen and your history.

PSA

PSA is prostate-specific antigen. NHS pages are clear that a high result can come from an enlarged prostate, infection, recent ejaculation, cycling or breathless exercise. A low result is no lifetime guarantee either. Routine population PSA testing isn't currently offered on the NHS, and the UK NSC still does not recommend population prostate screening.

NICE NG12 uses PSA, with age-banded thresholds, for men who already have urinary symptoms, erectile dysfunction or visible haematuria. On Elite, PSA for men over 40 is extra information, read with the examination and the ultrasound.

CA-125

CA-125 is the marker NICE uses in primary care for persistent symptoms that suggest ovarian cancer, followed by ultrasound depending on the result. The UK NSC does not recommend population screening for ovarian cancer. The UKCTOCS trial found that screening with CA125 or ultrasound did not reduce deaths from the disease. On Elite, CA-125 sits next to pelvic ultrasound and a gynaecologist, and it's that combination that does the work.

If you'd like a single named marker without an examination, the laboratory service at blood.london offers cancer marker tests individually. A MOT brings a consultation, an examination and a review to the same numbers.

What does Ultimate add for women?

The Ultimate Health MOT starts at £2,950 without gynaecology and £3,350 with it. Allow 3 to 4 hours, including 60 to 90 minutes of MRI of the brain, intracranial and carotid MRA, whole spine and torso. For women it adds HE4 and a ROMA score on top of CA-125. Because it includes Elite's bloods, it also carries CEA, and PSA for men from 40.

ROMA is a calculation that combines HE4, CA-125 and menopausal status. Some secondary-care teams use it to help sort pelvic masses. It's a risk calculation, not a screening test or a verdict. NICE HealthTech guidance (formerly DG31, now HTG453) found there was not enough evidence to recommend routine adoption of ROMA in NHS secondary care to decide whether to refer people with suspected ovarian cancer to a specialist multidisciplinary team.

So the score is read with the ultrasound, your history and, on Ultimate, the MRI and the gynaecology option if you booked it. Each piece has its quirks. HE4 can rise for non-cancer reasons. CA-125 can rise with endometriosis, fibroids, menstruation and other inflammation. MRI can show an ovarian cyst that was never going to matter.

Markers can't see structure and scans can't measure chemistry, which is why the doctor reads both alongside an examination. A clear MRI is one picture among several, and a raised marker with a quiet scan still gets a plan.

What does a flag on my report mean?

Laboratories mark results against a reference range. A flag means look again. A result inside range means that test, on that day, showed no abnormality of that kind. That's a narrower statement than every tissue being free of disease. That's the limitation NICE has in mind when it keeps these tests inside symptom-led guidance.

If something comes back raised, the doctor who examined you decides whether to repeat it, watch it, add a scan or refer you. Our FAQ covers what happens if something is found, from the explanation to referral letters. What happens after a Health MOT flags something walks through the next step. That review is part of every MOT, so a marker never arrives as a lone printout.

Which MOT suits your question?

Book the Elite Health MOT if you want markers read beside an examination and sex-specific ultrasound. Choose Ultimate if the MRI protocol plus the extra ovarian markers is the question you have. If your question is bowel, breast, prostate or lung, choose an organ package from our cancer screening list. It gives you FIT, mammography, prostate MRI or low-dose CT, the tests built for those organs.

Whichever you choose, keep going to the NHS screening you're invited to. Questions before booking? Call The Health Screening Clinic on 020 7183 7056.

Getting an accurate reading

• If you smoke, say so, because CEA moves with it.
• Mention an enlarged prostate, a recent urine infection or yesterday's bike ride, because PSA moves too.
• Tell us if you're on your period or have endometriosis or fibroids, since all of these can shift CA-125.
• Bring previous marker results, so a flag can be read as a trend.
• Fast for a minimum of four hours for Elite and Ultimate, keep taking your regular medicines unless told otherwise, and leave time for the review.

Markers are designed for people who feel well enough to be screened. If you have bloating, urinary symptoms, rectal bleeding, a new lump, or any new, severe or worsening symptom, see a GP or get urgent assessment. In an emergency, call 999 or go to A&E.

Frequently asked questions

Are tumour markers a cancer screen?

They're clues inside a doctor-led MOT, from Elite upwards. NICE NG12 uses PSA and CA125 for people with symptoms, not as general cancer tests, and the UK NSC has not recommended a general cancer blood test.

Which markers sit on Elite?

CEA for everyone, PSA for men over 40, and CA-125 for women. The doctor reads them with your examination and sex-specific ultrasound.

What does Ultimate add?

For women, HE4 and a ROMA score alongside CA-125, on top of the MRI protocol. ROMA is a calculation, not a verdict, and NICE has not recommended routine NHS adoption of ROMA for referral decisions.

If a marker is raised, do I have cancer?

A raised marker means the doctor looks again. Smoking, inflammation, benign prostate enlargement, cysts and other non-cancer causes can all lift markers. The doctor who examined you decides whether to repeat, watch, image or refer.

If a marker is normal, am I clear?

It means that marker was in range on the day. Markers can miss disease as well as over-flag it, so imaging and examination are read alongside them. If a new symptom appears after a reassuring report, get it checked.

Can I just order the named tests without a MOT?

Individual marker tests sit with the laboratory service at blood.london. A MOT adds a consultation, an examination and a review, with imaging from Elite.

What should I do about a new symptom?

See a GP or get urgent assessment, so the symptom itself is examined. Call 999 or go to A&E in an emergency.

Sources

• NICE. Suspected cancer: recognition and referral (NG12)
• NICE. Tests in secondary care to identify people at high risk of ovarian cancer (HTG453)
• UK National Screening Committee. Ovarian cancer
• UK National Screening Committee. Principles of screening
• NHS. PSA test
• The Health Screening Clinic. Can a blood test detect cancer?
• General Medical Council. Medical register, Mohammad Bakhtiar, 4694470

Written By

Stephen Lingam

Managing Director

Managing Director of Medical Express Clinic and the Health Screening Clinic since 1984. Over 40 years of operational experience in private healthcare on Harley Street, overseeing patient care, clinical standards, and service delivery.

Medically Reviewed

Dr Mohammad Bakhtiar

MD, PhD, LRCP, MSc, DHMSA

Clinical Lead

GMC: 4694470

Leading our clinical team with a focus on comprehensive men's health and preventative oncology protocols.

Last reviewed: 25/09/2026