CA19-9 Levels: What a Decrease Means for Cancer Risk - Gastroenterology and Hepatology

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CA19-9 elevated for four consecutive years - part 2


Hello Doctor: I previously consulted you about my elevated CA 19-9 levels, which have been high since 2009.
After a recheck at the end of November last year, my CA 19-9 level was 117.
Two and a half months later, in early February this year, my CA 19-9 level decreased slightly to 109.
I would like to ask you, given that my CA 19-9 level decreased from 117 to 109 over two and a half months, can this indicate a lower likelihood of cancer? I have heard that if it were cancer, the CA 19-9 level would show a significant increase within a month.
Thank you!

David, 30~39 year old female. Ask Date: 2014/02/05

Dr. Chen Qifeng reply Gastroenterology and Hepatology


Hello: CA 19-9 is a marker with high sensitivity but low specificity.
It can be elevated in cases of benign tumors, malignant tumors, and other conditions.
Additionally, factors such as race and individual constitution can significantly influence the levels.
Generally speaking, if gynecological and gastrointestinal examinations show no issues, it is recommended to monitor through blood tests.
For you, it may simply be a normal value influenced by your racial background and constitution.
Wishing you peace and good health.
Sincerely, Dr.
Chi-Feng Chen, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2014/02/05

More Info


CA19-9 is a tumor marker primarily associated with pancreatic cancer, but it can also be elevated in other conditions, including cholangiocarcinoma, hepatocellular carcinoma, and various benign diseases. Your situation, where CA19-9 levels have shown a slight decrease from 117 to 109 over a period of two and a half months, is indeed noteworthy and can provide some reassurance regarding the risk of cancer.

Firstly, it is essential to understand that CA19-9 is not a definitive diagnostic tool for cancer. While elevated levels can indicate the presence of malignancy, they can also be influenced by a range of non-cancerous conditions such as pancreatitis, liver disease, and even certain gastrointestinal disorders. The normal range for CA19-9 is typically considered to be below 37 U/mL, and levels above this threshold warrant further investigation, particularly when they are significantly elevated.

In your case, the decrease in CA19-9 levels from 117 to 109 suggests a stabilization or potential improvement in the underlying condition that may be causing the elevation. While it is true that in cases of malignancy, one might expect to see a more pronounced increase in CA19-9 levels over a short period, the fact that your levels have decreased could indicate that cancer is less likely, particularly if you are not experiencing any symptoms or other concerning clinical findings.

Moreover, the stability of your CA19-9 levels over time, especially considering that they have been monitored since 2009, is an important factor. If there were a malignancy, one would typically expect to see a more consistent upward trend in the levels, especially if the cancer were aggressive. The absence of significant changes in your CA19-9 levels over the years, along with the recent slight decrease, may suggest that your elevated levels could be related to benign conditions rather than a malignant process.

It is also worth noting that individual factors, including genetics, ethnicity, and underlying health conditions, can influence CA19-9 levels. For instance, some individuals may have persistently elevated CA19-9 levels due to chronic conditions without any underlying malignancy. Therefore, it is crucial to interpret these results in the context of your overall health and any other diagnostic findings.

In conclusion, while a decrease in CA19-9 levels from 117 to 109 is a positive sign and may suggest a lower risk of cancer, it is essential to continue monitoring and follow up with your healthcare provider. Regular check-ups and additional imaging or diagnostic tests may be warranted to ensure that any underlying issues are appropriately addressed. Always consult with your physician regarding any concerns or symptoms you may have, as they can provide personalized advice based on your complete medical history and current health status.

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