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Carcinoembryonic antigen screening: pros and cons.
1Department of Medicine, Saint Vincents Comprehensive Cancer Center, New York, NY 10011, USA.
Seminars in Oncology
|October 21, 1999
Summary
Plasma carcinoembryonic antigen (CEA) monitoring is not effective for screening colon cancer. Postoperative CEA monitoring may detect recurrence earlier, but its impact on survival and cost-effectiveness requires further study.
Area of Science:
- Oncology
- Clinical Chemistry
Background:
- The clinical utility of plasma carcinoembryonic antigen (CEA) in colorectal cancer management remains debated.
- CEA lacks sensitivity for colon cancer screening in the general population.
Purpose of the Study:
- To evaluate the role of CEA monitoring in colorectal cancer management, particularly after curative resection.
- To assess if CEA monitoring aids in early detection of recurrent disease for potential surgical cure.
Main Methods:
- Review of existing literature on CEA monitoring in colorectal cancer.
- Analysis of CEA's effectiveness in screening, chemotherapy monitoring, and post-surgical surveillance.
Main Results:
- CEA is ineffective as a screening tool for colon cancer.
- CEA monitoring during chemotherapy correlates with disease progression/improvement but lacks proven survival benefit.
- Postoperative CEA monitoring detects recurrence approximately 5 months earlier than standard follow-up.
- Surgical resection of metastases detected by CEA monitoring offers potential cure for some patients.
Conclusions:
- CEA monitoring is not recommended for colon cancer screening.
- While CEA monitoring can detect early recurrence post-surgery, its impact on survival and cost-effectiveness needs validation through large randomized trials.