CEA Levels: Do You Need Colon Cancer Screening?

Q: CEA Levels: Do You Need Colon Cancer Screening?

Hello： The normal value for CEA is <4, which can be monitored every three to six months or during a general health check-up. <br>(A) Alternatively, a colonoscopy or barium enema can be performed. <br>(B) CEA levels can be elevated due to (1) malignant tumors such as those in the

Carcinoembryonic Antigen (CEA)

Recently, I underwent a physical examination due to constipation and hemorrhoids.
The results showed a carcinoembryonic antigen (CEA) level of 3.1 µg/L.
My stool is hard but there is no occult blood.
I do not smoke.
Should I be screened for colorectal cancer, and what tests can be done? Additionally, besides cancer, what other factors can cause an elevation in CEA levels?

Xinji Ren, 40~49 year old female. Ask Date: 2005/03/01

Dr. Chen Sirong reply Oncology

Hello: The normal value for CEA is <4, which can be monitored every three to six months or during a general health check-up.
(A) Alternatively, a colonoscopy or barium enema can be performed.
(B) CEA levels can be elevated due to (1) malignant tumors such as those in the gastrointestinal tract, pancreas, lungs, uterus, ovaries, breasts, and urinary tract; however, CEA is not specific.
(2) Some benign conditions can also cause an increase in CEA, such as alcoholic liver cirrhosis, ulcerative colitis, benign breast cysts, and emphysema, but since you are 40 years old and do not smoke, these benign conditions are unlikely.
(C) A level of 3.1 is still below the normal range, so there is no need to be anxious.
Sincerely, Dr.
Chen Sih-Rong, Oncology.

Reply Date: 2005/03/01

More Info

Understanding CEA Levels: Do You Need Colon Cancer Screening?
The carcinoembryonic antigen (CEA) test is a blood test that measures the level of CEA in your blood. CEA is a protein that can be found in higher levels in individuals with certain types of cancers, particularly colorectal cancer. However, it is important to note that elevated CEA levels are not exclusive to cancer and can be influenced by various benign conditions as well.

In your case, with a CEA level of 3.1 µg/L, which is below the commonly accepted threshold of 4.0 µg/L for concern, it is generally considered within the normal range. However, given your symptoms of constipation and hemorrhoids, it is prudent to consider further evaluation to rule out any underlying issues, including colorectal cancer.

Should You Get Screened for Colon Cancer?
Given your age and symptoms, it is advisable to undergo screening for colorectal cancer. The American Cancer Society recommends that individuals at average risk begin screening at age 45. Since you are experiencing gastrointestinal symptoms, a more proactive approach is warranted.
The most common screening methods include:
1. Colonoscopy: This is the gold standard for colorectal cancer screening. It allows for direct visualization of the colon and rectum, and if any polyps or suspicious lesions are found, they can be biopsied or removed during the procedure. Given your symptoms, a colonoscopy would be a highly recommended option.

2. Flexible Sigmoidoscopy: This is a less invasive procedure that examines the lower part of the colon. However, it may not be as comprehensive as a full colonoscopy.

3. Stool Tests: Tests such as the fecal immunochemical test (FIT) or the multi-target stool DNA test can be used to screen for signs of colorectal cancer. However, these tests are typically used as initial screening tools and may lead to a colonoscopy if results are abnormal.

Other Factors Influencing CEA Levels
It is essential to understand that CEA levels can be elevated due to various non-cancerous conditions, including:
- Benign Conditions: Conditions such as inflammatory bowel disease (IBD), pancreatitis, liver disease, and even smoking can lead to increased CEA levels.

- Other Cancers: CEA can also be elevated in cancers of the lung, breast, pancreas, and stomach, among others. Thus, it is not specific to colorectal cancer.

- Age and Gender: CEA levels can vary based on age and gender, with some studies indicating that levels may be higher in older adults.

Conclusion
In summary, while your current CEA level of 3.1 µg/L is not alarming, your symptoms warrant further investigation. A colonoscopy would be a prudent next step to ensure that any potential issues are identified and addressed early. Additionally, it is crucial to discuss your family history and any other risk factors with your healthcare provider, as these can influence your screening strategy. Regular monitoring and proactive screening are key components in the early detection and prevention of colorectal cancer.

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