Related Experiment Video
Updated: Jun 26, 2026
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
How do we interpret an elevated carbohydrate antigen 19-9 level in asymptomatic subjects?
1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea.
Insights
Elevated cancer antigen 19-9 (CA 19-9) levels in asymptomatic patients warrant further investigation, not screening. Persistent elevation requires work-up to determine the underlying cause, as malignancy is rare.
Area of Science:
- Oncology
- Clinical Chemistry
Background:
- Cancer antigen 19-9 (CA 19-9) is a tumor marker.
- Elevated CA 19-9 levels can be associated with various conditions, including malignancies and benign diseases.
Purpose of the Study:
- To investigate the causes of elevated CA 19-9 levels in asymptomatic individuals.
- To establish guidelines for managing asymptomatic patients with elevated CA 19-9.
Main Methods:
- Prospective cohort study of asymptomatic patients with CA 19-9 >37 U/mL.
- Serial CA 19-9 monitoring and further diagnostic studies based on trend.
- Follow-up duration of at least 6 months.
Main Results:
- 0.8% of 62,976 patients had elevated CA 19-9.
- Of 353 followed subjects, 2.8% were diagnosed with malignancies.
- 27.5% had benign diseases, and 69.7% were non-specific.
Conclusions:
- CA 19-9 is not a reliable screening tool.
- Persistently elevated CA 19-9 necessitates etiological investigation.
Aim:
This prospective cohort study aimed to evaluate the etiology of elevated CA 19-9 levels and to present appropriate guidelines for the asymptomatic patients.
Methods:
Between January 2004 and March 2007, we enrolled consecutive asymptomatic patients who had elevated CA 19-9 levels >37 U/mL. To evaluate the etiology, the CA 19-9 level was rechecked and further studies were carried out. If the CA 19-9 level decreased to the normal range, or if it showed a decreasing trend, then it was monitored annually. Yet, if the CA 19-9 level showed an increasing trend, then the level was monitored at intervals of 1, 3, and 6 months until no evidence of malignancy was proven.
Results:
Of the 62,976 patients, 501 (0.8%) subjects showed an elevated CA 19-9 level. This prospective analysis was conducted on 353 subjects (70.5%) who were followed up for at least 6 months. Ten patients (2.8%) were diagnosed with malignancies. There were 97 patients (27.5%) with benign diseases and 246 patients (69.7%) were deemed non-specific.
Conclusions:
CA 19-9 should not be used as a screening tool. In the case of a persistently elevated CA 19-9 level, further work-up for determining the etiology should be done.
More Related Videos
08:49Printed Glycan Array: A Sensitive Technique for the Analysis of the Repertoire of Circulating Anti-carbohydrate Antibodies in Small Animals
Published on: February 14, 2019
08:01Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
