what is a high cea level for colon cancer

Full Answer

What is considered a high CEA level?

Levels of CEA higher than 20 ng/mL are considered very high. If you have CEA levels this high and you also have symptoms of cancer, it strongly suggests the cancer has not been removed successfully after treatment. It may also suggest that the cancer has metastasized, or spread, to other parts of your body. Click to see full answer

Does CEA increase mean a relapse of colon cancer?

It is necessary a visit to your doctor to get a proper treatment. If the CEA blood test is performed after a treatment for cancer, such as colorectal cancer, a severe CEA increase is a sign of a poor prognosis. It may suggest a relapse of the cancer or metastasis. A CEA value over 100 ng/ml is usually a sign of metastasis.

How high can CEA levels go?

The CEA is measured in the blood and the normal range is <2.5 ng/ml in an adult non-smoker and <5.0 ng/ml in a smoker. The most common cancers that elevate CEA are in the colon and rectum but it can be elevated with gastric, ovarian and other cancers.

What is normal CEA level?

What Is the Normal CEA Level? The normal value for those taking a CEA, or carcinoembryonic antigen, blood test is 0 to 2.5 micrograms per liter, according to MedlinePlus. For smokers, the normal value range is 0 to 5 micrograms per liter. The test does not directly identify cancer but can indicate its presence, explains MedlinePlus.

What is a high CEA level for stage 3 colon cancer?

The relationship between CEA levels and TNM staging of patients is shown in Table 3. Cases with CEA ≤5 ng/mL were predominantly in the Stage III, whereas those with CEA >5 ng/mL were intensely in the Stage IV.

What is a normal CEA level in colon cancer?

The CEA is measured in the blood and the normal range is <2.5 ng/ml in an adult non-smoker and <5.0 ng/ml in a smoker. The most common cancers that elevate CEA are in the colon and rectum but it can be elevated with gastric, ovarian and other cancers.

How high do CEA levels go?

The reference range is 0-2.9 ng/mL of blood. Generally, healthcare providers consider typical CEA levels to be between 0 and 2.9 ng/mL. Research indicates that false-positive results are reported with concentrations as high as 35 ng/mL.

What is a high CEA tumor marker?

CEA is a type of tumor marker. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in the body. A high level of CEA can be a sign of certain types of cancers. These include cancers of the colon and rectum, prostate, ovary, lung, thyroid, or liver.

What is a good CEA number?

The normal range is 0 to 2.5 ng/mL (0 to 2.5 µg/L). In smokers, slightly higher values may be considered normal (0 to 5 ng/mL, or 0 to 5 µg/L).

Is a CEA of 9 high?

A high CEA level was defined as a level exceeding 5 ng/ml, and a high CA19-9 level was defined as a level exceeding 37 U/ml, according to the guidelines defined by the manufacturer of the test kit.

How do I lower my CEA levels?

Thus, we suggest that exercise for 2-3 days per week decreases the expression of CEA and improves body condition, without loading fatigue or stress, which may contribute to preventing cancer in the elderly women.

How reliable are CEA markers?

Doctors don't use the CEA test to make a first-time diagnosis of cancer. This test isn't an accurate way to screen for it because many other diseases can cause the levels of this protein to rise. And some people with cancer don't have high CEA levels.

Can stress raise CEA levels?

Our findings clearly indicated that immobilization stress results in enhanced serum CEA level whether the stress is acute or chronic. Consistent with our finding, there are reports suggesting that stress can increase tumor growth and tumor marker expression [26, 27].

Is CEA level 4 high?

The normal range for CEA is 0 to 2.5 nanograms per milliliter of blood (ng/mL). If CEA levels remain elevated during treatment, your treatment may not have been as successful as hoped. Anything greater than 10 ng/mL suggests extensive disease, and levels greater than 20 ng/mL suggest the cancer may be spreading.

What does a CEA level of 8 mean?

A CEA value of greater than 8 ng/ml was highly suggestive of residual disease or recurrence, even when no clinical evidence was present. Approximately 90% of the patients dying from colorectal cancer showed an increase in CEA to greater than 8 ng/ml during the course of the disease.

Can CEA go up and down?

Serum CEA levels fluctuate over time in healthy individuals, and the intraindividual variation has been reported to be about 30% [19].

Do all colon cancers produce CEA?

CEA is secreted by a variety of solid tumors, including 90% of colorectal cancers (3). As the single most important and reliable serum prognostic biomarker in colorectal cancer, elevated preoperative CEA levels are found to be associated with worse prognosis of colorectal cancer (4–9).

What labs are abnormal with colon cancer?

CA 19-9 is a blood marker that may be elevated in colorectal cancer. Imaging Studies: These tests allow your doctor to see if the cancer has spread to other parts of the body. You may have a CT scan of your chest, abdomen and pelvis. Your doctor may also request MRI scans.

Can CEA be normal with cancer?

A normal result is typically less than 2.5 nanograms per milliliter. Results might vary between labs. A higher-than-normal CEA level that increases over time might signal that your cancer has grown or has come back after treatment. But high levels of CEA do not always mean you have cancer.

Is it normal for CEA levels to fluctuate?

Serum CEA levels fluctuate over time in healthy individuals, and the intraindividual variation has been reported to be about 30% [19].

What is the normal range for a CEA test?

The CEA is measured in the blood and the normal range is <2.5 ng/ml in an adult non-smoker and <5.0 ng/ml in a smoker. The most common cancers that elevate CEA are in the colon and rectum but it can be elevated with gastric, ovarian and other cancers. The CEA test most often used for post colon cancer treatment surveillance ...

What causes CEA blood levels to increase?

The most frequent cancer which causes an increased CEA is cancer of the colon and rectum. Benign conditions which can elevate CEA include smoking, infections, inflammatory bowel disease, pancreatitis, cirrhosis of the liver, and some benign tumors in the same organs in which an elevated CEA level indicates cancer.

Can CEA be high without having cancer?

Yes, elevations in CEA and CA 19-9 levels may occur in patients without cancer. In fact studies suggest that falsely elevated levels may occur in up to 50% of colon cancer patients post treatment leading to unnecessary anxiety and testing.

What is the Carcinoembryonic antigen (CEA)?

CEA is an antigen (small protein) that is found on the surface of colon, rectal, gastric and other types of cancer cells and high levels of CEA can be detected in the blood of some patients with cancer and the developing fetus. The CEA is measured in the blood and the normal range is <2.5 ng/ml in an adult non-smoker and <5.0 ng/ml in a smoker. The most common cancers that elevate CEA are in the colon and rectum but it can be elevated with gastric, ovarian and other cancers. The CEA test most often used for post colon cancer treatment surveillance and is likely to be replaced with ctDNA over time.

Can CEA levels increase with chemotherapy treatment?

Yes, CEA "flares" during chemotherapy don't mean the cancer is progressing. Cancer patients whose CEA blood tests rise at the beginning of chemotherapy and then fall (CEA flare) do better than patients with a consistently rising CEA.

How do oncologists use the CEA level?

Historically the main role for CEA has been in post colorectal cancer treatment surveillance along with clinical evaluation and CT/PET scans. Rising CEA levels may indicate a cancer recurrence sooner than PET/CT detection however this doesn't necessarily translate into improved survival. Moreover a high CEA level may occur falsely leading to significant anxiety and unnecessary tests to look for a recurrence that doesn't exist.

What antigen is associated with survival?

According to an article recently published in the Journal of Clinical Gastroenterology, levels of the carcinoembryonic antigen (CEA) and albumin (ALB) are associated with survival among patients with early colorectal cancer.

What is the sensitivity of a CEA test?

[16] The sensitivity was 36% with a specificity of 87% for a CEA > 2.5 ng/mL in patients with stage I and II disease . [16] The sensitivity for stage III and IV disease at similar CEA levels was 74% and 83%, respectively. [16] The sensitivity decreased while the specificity increased for higher CEA cutpoints (5 ng and 10 ng). [16] The poor reliability of this test in early colorectal cancer and the imperfect specificity in the normal population makes this test unsuitable for primary colorectal cancer screening.

How often is CEA measured?

In a follow-up of 311 patients with potentially curative resections of colorectal cancer, CEA was measured every 3 months for 2 years, then every 6 months for 3 years. [20] The sensitivity of CEA in detecting recurrence was 58%, with a median lead time of 6 months. The sensitivity was the highest for the hepatic metastases group (80%). The specificity, positive predictive value, and negative predictive value were 93%, 79%, and 83%, respectively. [20]

How much does CEA cost?

Limited data are available regarding the cost-effectiveness of CEA in detecting potentially curable recurrences. In the follow-up of patients receiving adjuvant therapy on a large randomized study of 1,356 patients, 2.2% of resectable recurrences were attributed to CEA screening. [28] The cost of CEA monitoring per detected resectable recurrence was $5,696, comparing favorably to colonoscopies and chest x-rays. [28] A recent study suggests a cost of $25,289 for each surviving patient after surgery for CEA detected recurrence. [45] Others have estimated that CEA costs are $500,000 per patient cured secondary to CEA screening, while some have suggested a range of $22,963 to $4,888,208 per quality-adjusted life-year saved. [46,47] Most estimates would be considered cost-effective when taking into consideration the current costs of treating metastatic colorectal cancer.

How long does it take for CEA to normalize after resection?

[17,18] This time frame of a few weeks to several months is consistent with an estimated CEA half-life of 3 to 13 days; longer half-lives are associated with higher preoperative CEA levels. [19]

Why is CEA monitoring important?

CEA monitoring is helpful in detecting early recurrences in patients with resected colorectal cancer. Early detection of disease recurrence will enhance the chances of curative intent resection, resulting in a positive impact in a select patient population. The percentage of patients rendered curable secondary to CEA monitoring is likely less than 5% based on the reviewed literature. Thus, a definite impact on overall survival is unlikely to be detected unless a large randomized study addressing this issue is conducted.

Is CEA rise false positive?

Given the possibility of false-positivit y of CEA levels during the surveillance of patients with resected colorectal primary or resected metastatic disease, it is prudent to confirm an ongoing rise in CEA prior to the initiation of an extensive disease recurrence work-up. The degree in CEA rise is important in estimating the likelihood of false-positivity: Elevations of more than 15 ng/mL are unlikely to reflect anything but disease recurrence. [22]

Does bolus fluorouracil increase CEA?

Figure 1 illustrates a surge in CEA during adjuvant bolus fluorouracil (5-FU) therapy in a patient with a resected rectal cancer. The surge in this case lasted for several weeks and resolved spontaneously; the patient remains free of disease more than 1 year later. In the follow-up of 1,017 patients with resected colon cancer, Moertel et al described a 16% false-positive rate of CEA elevation when a cutoff of 5 ng/mL was used and a 4% false-positive rate when 10 ng/mL was used. [22] This was attributed to 5-FU and levamisole in the majority of cases. [22] These findings are consistent with preclinical data demonstrating an increased expression of CEA in response to chemotherapy exposure when agents such as 5-FU and platinum drugs are used. [70,71]

What is CEA used for?

Serum CEA is widely used in the management of patients with colorectal cancer to evaluate response to treatment as well as to detect recurrence of disease .

Is CEA a predictor of survival?

Results from a retrospective, single-center, cohort study of patients with stage I-III colorectal cancer who underwent surgery showed preoperative serum carcinoembryo nic antigen (CEA) level was an independent predictor of survival. The findings from this study were published in Annals of Surgical Oncology.

Is CEA a predictor of cancer?

CEA Level as an Independent Predictor of Clinical Outcome in Colon Cancer. NCCN guidelines currently say that an elevated serum CEA level is not a high-risk factor that would preclude the use of adjuvant chemotherapy for early-stage colorectal cancer.

What are the limitations of CEA?

Limitations of CEA testing 1 If CEA is negative, it does not guarantee that the cancer has not come back. 2 If CEA is positive, it does not mean that the cancer has come back. Test results may need to be repeated or confirmed by additional tests.

What does it mean if your CEA level is not down after surgery?

If your CEA level does not go down after surgery, it could mean that you may have residual or leftover cancer in your body. It could be metastatic (usually in the liver or in the lungs) or not completely removed after surgery. If this is the case, you will have imaging to determine where the cancer may be and determine next steps with your doctor.

When and how should I have CEA biomarker testing?

Your doctor will test your blood for CEA levels after you are diagnosed with colorectal cancer, during treatment, and during follow-up visits.

What happens if you have cancer before surgery?

If you were diagnosed with locally advanced cancer and are treated with chemotherapy before or after your surgery, your doctor will test your CEA levels during the course of treatment to make sure the treatment is effective, and killing the cancer cells.

What happens if you have a negative CEA?

If CEA is negative, it does not guarantee that the cancer has not come back. If CEA is positive, it does not mean that the cancer has come back. Test results may need to be repeated or confirmed by additional tests. For more on side effects of other chemotherapy regimens, click here.

What test is used to confirm cancer?

To confirm that cancer returned (recurrence), it is important to repeat the test and also use imaging, such as a chest X-ray, abdominal ultrasound, abdominal, chest and pelvic CT. You may also have a colonoscopy.

Is CEA biomarker test 100% correct?

While CEA biomarker testing is a very common procedure for detecting colorectal cancer growth and division, it has some limitations because the results are not always 100% correct. If CEA is negative, it does not guarantee that the cancer has not come back.

What is the cutoff value for upper normal CEA?

The cutoff value for upper-normal CEA was 5 ng/ml. Initial CEA and r-CEA was measured within 2 months before treatment or detection of recurrence, respectively. The date of recurrence was defined as the date when clinicians confirmed recurrence and described recommendation for following management in medical records. LRR was defined as any recurrence within the pelvis; DM was defined as any extrapelvic recurrence.

Why is CEA differentially expressed in rectal cancer?

The reason why serum CEA is differentially expressed in initial and recurrent rectal cancer is unclear. It might be simply due to different tumor burden as shown in metastatic colon cancer study reporting relationship between CEA level and radiologic tumor burden [18]. On the other hand, initial and recurrent tumor might have different biology. Chang et al. failed to demonstrate that location of tumor involvement induces discrepancy between CEA level of primary and recurrent cancer [19]. Several literatures proposed possible explanations why high CEA level is associated with poor prognosis [20, 21]. Jessup et al. [20] suggested that CEA-producing tumors have higher tumorigenic potential and ability to spread distantly that might be facilitated by its role in cell adhesion. Recent experimental data suggest that an adoptive immune reaction of CEA-specific T-cells causes enteropathy, resulting in loss of mucosal integrity with increased epithelial leakage facilitating tumor growth or recurrence [21]. Whatever caused elevation of CEA (e.g., residual tumor burden or aggressive tumor biology), clinicians can expect poor survival of patients with elevated r-CEA level. If we can select the patients with short expected life accurately, we can spare aggressive treatment and focus on palliation since salvage treatment involves possibility of adverse effect as well as requires excessive medical costs. Although r-CEA alone is not enough for accurate calculation of expected survival, this study suggests that r-CEA is one of the key factors predicting survival in recurrent rectal cancer.

Why should CEA be monitored?

Not to mention, monitoring of serum CEA should be done even for tumors with normal pre-CEA because approximately one-fourth of tumors with initially normal CEA show elevated CEA level in recurrent disease.

What is the prognostic impact of pretreatment CEA?

Recently, a Korean multi-institutional study found that patients with elevated pre-CEA have lower recurrence-free survival (RFS) and overall survival (OS) than patients with normal pre-CEA (5-year RFS 74.2% vs. 63.5%, p< 0.001 and 5-year OS 86.9% vs. 81.8%, p= 0.001) among rectal cancer patients treated with neoadjuvant chemoradiotherapy (NACRT) and surgery, even after propensity score matching to control covariates including stage [11].

What is the most widely used tumor marker for screening test, predicting treatment response and survival, and detecting re?

Serum carcinoembryonic antigen (CEA) is one of the most widely used tumor markers for screening test, predicting treatment response and survival, and detecting recurrence in colorectal cancer [1–4]. CEA was first identified in human colon carcinoma tissue extracts and is a glycoprotein on the surface of colonic epithelial cells and known to play a critical role as a ligand in cancer dissemination [4]. Elevated serum CEA is found in 17∼47% of colorectal cancer patients [5, 6].

Does CEA increase after rectal cancer?

However, evidence is limited regarding prognostic impact of elevated CEA in recurrent rectal cancer. Some patients with elevated CEA at diagnosis recur without r-CEA elevation and vice versa. Is the r-CEA also associated with remaining survival of the patients as initial CEA is associated with DFS in primary cancer? The current study found that CEA at the time of recurrence is related to survival after recurrence in recurrent rectal cancer. The 5-year survival rate following recurrence was significantly lower in patients with elevated r-CEA than the patients without elevation of r-CEA even in multivariate analysis including initial CEA (HR 2.508, 95% CI 2.014-3.124, p= 0.001, Table ​Table22).

Is CEA a marker for recurrence?

CEA is also demonstrated as useful markers for detecting recurrence [1–4]. Most current guidelines recommend checking serum CEA regularly following treatment as a way to detect recurrent disease [1, 15]. However, prognostic impact of CEA at the time of recurrence (r-CEA) in recurrent rectal cancer has not been addressed. This study investigated the prognostic impact of elevated r-CEA on survival in recurrent rectal cancer.

What does it mean when your CEA is elevated?

Severe CEA (Carcinoembryonic Antigen) increase (> 20 ng/ml in adults): A severe CEA increase is usually a sign of a malignant tumor ( colorectal or pancreatic cancer). It is necessary a visit to your doctor to get a proper treatment. If the CEA blood test is performed after a treatment for cancer, such as colorectal cancer, ...

What is the normal range for a CEA increase?

You can talk to your doctor about it. Moderate CEA (Carcinoembryonic Antigen) increase (10 - 20 ng/ml in adults): A moderate CEA increase requires a visit to your doctor to study the possible causes.

What does a high CEA (Carcinoembryonic Antigen) mean?

Carcinoembryonic antigen (CEA) can be higher than the normal range in a blood test for the following reasons:

What causes a CEA increase?

A moderate CEA increase requires a visit to your doctor to study the possible causes. A large number of malignant tumors can increase the carcinoembryonic antigen (CEA) level in the blood. There are also some benign conditions that may increase the CEA level in the blood such as inflammatory bowel diseases (ulcerative colitis, diverticulitis, ...

How to lower CEA in blood test?

What can I do to lower the CEA (Carcinoembryonic Antigen) in a blood test? If CEA is a bit high in a blood test and you want to lower the level the first step is to give up smoking. Tobacco is one of the main causes for a CEA elevation in the blood.

What does a CEA increase mean?

If the CEA blood test is performed after a treatment for cancer, such as colorectal cancer, a severe CEA increase is a sign of a poor prognosis. It may suggest a relapse of the cancer or metastasis. A CEA value over 100 ng/ml is usually a sign of metastasis.

What drugs raise CEA?

There are some health circumstances or drugs than can raise the CEA (Carcinoembryonic Antigen) in a blood test: Pregnancy. Chemotherapy. X-ray. Tobacco. Injury. Drugs. Anticoagulants. Heparin.

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