Initial examinations for skeletal metastasis we selected two or three tumor markers to test for from among the following: serum CEA (carcinoembryonic antigen), CA19-9 (carbohydrate antigen 19-9), CA125 (cancer antigen 125), AFP (alpha-fetoprotein), PSA (prostate-specific antigen), CA15-3 (carbohydrate antigen 15-3) and SCC (squamous cell carcinoma antigen). We measured AFP in patients with liver dysfunction in which hepatocellular carcinoma was suspected, CA125 in women with a history of gynecological cancer or with gynecological symptoms, SCC in patients who were suspected to have squamous cell carcinoma from lung images and PSA in men with osteosclerotic lesions. The final choice of tumor markers to test for was made by the doctor in charge of each patient. Measurements were made by chemiluminescent enzyme immunoassay.