Parminder Kaur*, Deepasheree Bapu and Mark Cheetham
Shrewsbury and Telford Hospital NHS Trust, UKFulltext PDF
Introduction: The role of Carcinoembryonic Antigen (CEA) as a prognostic marker after colorectal cancer resection with a curative intent is well understood. However, CEA is not a sensitive or specific test for the initial diagnosis of colorectal cancer. Despite this, there has been an increase in the use of CEA testing in the primary care setting for patients with no formal diagnosis of cancer. Aim: Our study aims to determine whether CEA testing within primary care setting is beneficial or justified. Materials and Methods: A retrospective review of all patients who had a serum CEA test sent to our trust laboratory from the primary care setting was performed. Patient records were then analyzed to determine whether CEA testing triggered a referral to the hospital and resulted in a diagnosis of cancer. Results: A total of 314 patients had a serum CEA checked by their General practitioners during the study period. 79% of the patients had a CEA level checked with no pre-test diagnosis of cancer. A total of 39% PF patients were referred to secondary care with 79% of these patients having a CEA level of less than 5 μg/ml. 12% of patients were not referred to secondary care despite an elevated CEA level of greater than 5 μg/ml. CEA levels were elevated in only 42% of the patients who had a subsequent diagnosis of cancer. Conclusion: CEA should not be used in the primary care setting as a diagnostic test or to determine whether a referral to the secondary care is indicated.
Colorectal Cancer; Carcinoembryonic antigen; Primary Care
Kaur P, Bapu D, Cheetham M. The Role of Carcinoembryonic Antigen (CEA) Testing in Primary Care - Does It Exist?. Clin Surg. 2019; 4: 2536..