A Review of the Role of Carcinoembryonic Antigen in Clinical Practice
- Study type
- Review article
- Design
- Systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines
- Sample size
- 2,712 articles identified, of which 34 were relevant
- Source
- Ann Coloproctol · 2019
In plain words
CEA is a substance measured in the blood that may be raised in colorectal (bowel) cancer. This review shows that a high CEA level before surgery is linked to more advanced disease, and if it does not return to normal after surgery, some cancer may remain or may have come back. However, measuring this test on its own does not improve survival, and if it is high, further tests are needed. Your own doctor will interpret the result and decide on the next step with you.
Key results
Study population
This is a systematic review and enrolled no patients. Articles were identified from PubMed, the Cochrane Library and controlled trial registries. They concerned the role of carcinoembryonic antigen (CEA) in colorectal cancer and the investigation of patients with a raised CEA.
Endpoints
The review aimed to determine the current role of CEA and the best way to investigate patients with a raised CEA. The abstract reports no specific primary or secondary endpoint.
Safety and side effects
This is a systematic review; no safety or treatment-related adverse-event data are reported in the abstract.
Clinical significance and place in guidelines
Based on this review, CEA plays an important role in the work-up, management and follow-up of patients with colorectal cancer. A raised preoperative CEA indicates more advanced disease and a worse prognosis, and failure of CEA to return to normal after surgery indicates residual or recurrent disease. The authors propose two algorithms for investigating a raised CEA after CRC resection and a new raised CEA. Because CEA measurement alone did not improve survival, it should be used alongside other investigations. The status of these algorithms in formal guidelines should be checked separately and is not mentioned in the abstract.
Limitations
The abstract does not state the study's limitations. Because only 34 of the 2,712 identified articles were included in the analysis and the proposed algorithms were derived from this review, their validity should be checked in the full paper and in prospective studies.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.