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1, it had largely met that goal.(Also on POLITICO: Obamacare fight erupts in deep blue Maryland)Enrollment figures for December, a critical barometer of public response, are not expected until January. But Obama said last week that more than 1 million people were now signed up for coverage in the new health insurance exchanges.

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Think it time to ask the question, Campbell said. think you have to ask the question because of what happening out there. It incumbent on me, because of my position, to ask the question. not afraid now to talk about the fact that we should look at fighting in hockey, he adds. think if you discussed this even three or four years ago you would have got pooh poohed out of the game.

Summary points Tumour markers can contribute usefully to patient management, but awareness of their limitations is essentialCarcinoembryonic antigen (CEA) is recommended for postoperative follow up of patients with stage II and III colorectal cancer if further surgery or chemotherapy is an optionProstate specific antigen (PSA) may be used for detecting disease recurrence and monitoring treatment in patients with prostate cancerIn some high risk patients, measurement of fetoprotein, CA125, or CA19 9 may aid early detection of hepatocellular carcinoma, ovarian cancer, or pancreatic cancer, respectivelyOpportunistic screening with panels of tumour markers is not helpful, nor is measurement of CA125 in men or PSA in womenTumour markers are molecules that may be present in higher than usual concentrations in the tissue, serum, urine, or other body fluids of patients with cancer.1 2 3 Serum tumour markers may aid cancer diagnosis, assess prognosis, guide choice of treatment, monitor progress during and after treatment, and/or be used as screening tests. Conservative estimates suggest that in the United Kingdom alone close to 15 million such measurements are made each year.If tumour markers are requested and interpreted correctly, they undoubtedly help clinical management. Somewhat alarmingly, however, a recent audit in a single Greek hospital found that only about 10% of requests for tumour markers were appropriate.4 The cost of inappropriate testing of tumour markers was estimated to be about 23974 (21000; $35000) a month, even without including the cost of unnecessary second level follow up investigations such as colonoscopy and ultrasonography.4 However, awareness of the limitations of tumour markers is crucial not only because of the economic implications of their misuse but even more importantly