Rising CEA Levels: Implications for Cancer Screening

Q: Rising CEA Levels: Implications for Cancer Screening

Mr. Wang An： 1. The normal reference ranges may vary each year due to differences in testing equipment or reagents. 2. A CEA level below 4 is generally considered normal. However, in the presence of cancer, CEA levels may not necessarily rise. Given your f

The CEA levels in the health checkup have been increasing year by year?

Doctor: Hello.
I am 52 years old and underwent surgery for a benign meningioma 25 years ago.
My father passed away from colorectal cancer a few years ago, and my mother had endometrial cancer but is doing well after surgery.
I do not smoke or drink alcohol, and I regularly undergo company health check-ups, having had five cancer screenings in the past nine years, including PSA and CEA tests.
The dates and values for these tests are as follows:
PSA [ng/ml]:
- 85/6: 1.13 (0-4)
- 88/1: 0.4 (0-4)
- 90/9: 1.16 (0-4)
- 92/9: 1.88 (0-4)
- 94/8: 2.35 (0-4)
CEA [ng/ml]:
- 85/6: 0.68 (<8)
- 88/1: 0.90 (0-5)
- 90/9: 0.80 (0-3)
- 92/9: 1.14 (0-3)
- 94/8: 2.35 (0-3.5)
I would like to ask the doctor:
1.
Why are the reference values used in each test not consistent?
2.
The CEA levels have increased each year, especially doubling from 1.14 in 1992 to 2.35 in 1994.
What does this signify? I have read in medical literature that the reference value for CEA should be <2.5.
Is this correct?
3.
Do I need further examinations? Thank you.

Wang'an, 50~59 year old female. Ask Date: 2005/12/09

Dr. Fan Sheng reply Oncology

Mr.
Wang An: 1.
The normal reference ranges may vary each year due to differences in testing equipment or reagents.
2.
A CEA level below 4 is generally considered normal.
However, in the presence of cancer, CEA levels may not necessarily rise.
Given your family history of colorectal cancer and your age, it is recommended that you include a colonoscopy in your annual health check-up for safety.
3.
CEA levels can increase not only in colorectal cancer but also in lung cancer, breast cancer, gastric cancer, pancreatic cancer, and biliary tract cancer, so please be cautious.

Reply Date: 2005/12/09

More Info

Understanding rising levels of Carcinoembryonic Antigen (CEA) is crucial for assessing cancer risk, especially given your family history and personal health background. CEA is a glycoprotein involved in cell adhesion, and its levels can be elevated in various conditions, particularly cancers such as colorectal, gastric, pancreatic, and lung cancers.
1. Variability in Reference Values: The reference values for CEA can vary between different laboratories due to differences in testing methods, equipment, and reagents used. Each lab establishes its own reference range based on the population it tests. This is why you may see discrepancies in the reference values across your tests. It’s essential to interpret your results in the context of the specific lab’s reference range.
2. Significance of Rising CEA Levels: Your CEA levels have shown a gradual increase over the years, with a notable jump from 1.14 ng/ml in 1992 to 2.35 ng/ml in 1994. While a CEA level below 5 ng/ml is generally considered normal, levels can be influenced by various factors, including smoking, inflammation, and benign conditions. The increase in your CEA levels, particularly given your family history of colorectal cancer, raises concern and warrants further investigation. The reference value you mentioned (<2.5 ng/ml) is a common threshold used in some studies, but it’s essential to consider the context of your overall health and family history.

3. Need for Further Testing: Given your rising CEA levels and family history of cancer, it is advisable to pursue further diagnostic evaluations. A colonoscopy is particularly important for you, as it can help detect any precancerous lesions or colorectal cancer early on. Additionally, imaging studies such as CT scans or MRIs may be warranted to rule out any malignancies or other underlying conditions. Regular monitoring of CEA levels can also provide insights into any changes over time, helping to guide further action.

In summary, while rising CEA levels can be indicative of potential malignancies, they are not definitive on their own. Given your personal and family medical history, it is prudent to consult with your healthcare provider about the appropriate next steps, including potential imaging studies and a colonoscopy. Early detection and intervention are key in managing cancer risk effectively.

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