The high incidence of tumor diseases has made the prevention and treatment of tumors become popular, and while people are saddened by the early deaths of celebrities due to tumors, they are also actively in need of better early diagnostic measures. Therefore, tumor screening and physical examination have become one of the important tasks of medical checkup centers and many medical structures. So, what are the problems and misunderstandings of tumor screening and what kind of examination should be done? Many people equate tumor screening with blood tumor marker tests, such as CEA, CA199, CA72.4, CA125, AFP and so on. Undeniably, the above tumor markers will be helpful for early targeting, such as AFP is meaningful for screening primary hepatocellular carcinoma, nearly 1/3 of gastrointestinal tumor patients are positive for CEA, and other blood tumor markers will be elevated to different degrees in the early stage of tumor. However, except for AFP, the percentage of elevated blood tumor markers in the early stage of malignant tumors is not high. In other words, a normal blood tumor marker test does not mean that there is no tumor. Another question is whether elevated blood tumor markers mean that there is definitely a tumor? The author often encounters this question in outpatient clinics. Tumor diagnosis must have imaging and pathological evidence, and it is not enough to rely solely on elevated blood tumor markers to diagnose tumor. We often choose the test that is most likely to give positive results according to the elevation of different blood tumor markers. Years ago, we encountered a case of breast cancer detected by elevated blood CA153, which is still fresh in our minds. The elevation of AFP is not only seen in liver cancer, but also in a few gastric cancers, teratomas, tumors of embryonic origin, hepatitis, etc. The elevation of CA199 can be seen in many digestive tumors, and there are cases of polycystic pancreas with significant elevation of CA199 rather than only pancreatic cancer. In a nutshell, the elevation of blood tumor markers only plays the role of prompting, is a clue, is a vine, but along the vine to the melon may not be, may be the leaf. In the author’s opinion, more attention should be paid to the complaints, i.e., self-perceived discomfort, in the physical examination. Common indications of tumorigenesis are unexplained bleeding, emaciation, inflammation, lumps, etc. People of any age and in any part of the body should pay enough attention to the above conditions. The phenomenon of “emphasizing on instruments and neglecting on consultation and examination” in the current medical checkup system can easily lead to missed diagnosis. It is obvious that only blood test for tumor in general physical examination program is far from enough. Tumors with the highest morbidity and mortality rates in China include lung cancer, stomach cancer, liver cancer, breast cancer, colorectal cancer, esophageal cancer and cervical cancer. As far as the tumor types with high incidence in Chinese population are concerned, only AFP has significance for early diagnosis, cervical smear is valuable for early detection of cervical cancer, early detection of digestive system tumors, including gastric cancer, esophageal cancer, colorectal cancer, etc., through fecal occult blood test and CEA test is very inefficient, and lung cancer detected by chest X-ray is often in advanced stage. In fact, the above mentioned tumors may also show certain discomforts in the early stage, such as irritating cough, mild hemoptysis, choking sensation after eating or post-sternal pain and discomfort, epigastric discomfort, blood in stool, and so on. Early symptoms combined with imaging and blood tests can help improve detection rates. The mentality of the examinee is to seek a negative test; a negative test is a relief, but a false negative test can lead to a misunderstanding of the disease; the examiner should seek a positive test in order to minimize missed diagnosis. Family history should also be asked during the physical examination to detect hereditary or high-risk patients. One point to be reminded is that the results of the physical examination can only be used as a reference. Many organizations have designed different physical examination packages, and the deluxe ones include new means such as PET-CT and biochip. There are many types of tumors, which cannot be fully covered by the current medical checkups, and the means of medical checkups also have certain limitations, and the sensitivity is not 100%. Therefore, you should not be confused by the gimmicks in the publicity of medical checkups, and it is most important to pay careful attention to the changes in your body. What kind of tests should be done in a medical checkup? First of all, you should introduce your concerns, discomforts and past medical history to the examining doctor, such as worrying about what types of tumors may appear, minor changes in your body and discomforts, which will prompt the doctor to do a targeted physical examination. If there is a history of hepatitis B for many years, then a targeted examination of the liver is necessary. Secondly, do not refuse body checkups, especially exposure checkups and anal fingerprinting, some of the findings are often unexpected discoveries. The majority of colorectal cancers in Chinese are rectal cancers, most of which are low to intermediate grade, and are detectable by anal diagnosis. The results of hematologic tests, including AFP and CEA, will be suggestive of further imaging. Again, targeted or intermittent imaging such as gastroscopy, colonoscopy, CT and even PET-CT are performed. In some areas of the United States, chest CT scanning has been approved for lung cancer screening, although it will increase the amount of radiation received by the human body, but the detection efficiency of lung cancer is significantly improved. In conclusion, physical examination is an important tool for early detection of tumors, but it is also a complex screening process. In this process, the active participation of the examinee, including the narration of his/her own discomfort, is particularly important, and a comprehensive physical examination is also very crucial, with appropriate auxiliary examinations as a necessary supplement.