Follow-up of moderately elevated serum CEA levels in "healthy patients"

In a retrospective analysis of 254 patients with a moderately elevated serum CEA level (3.6 to 10.0 ng/ml) a satisfactory explanation for the increased CEA level could not be identified in 42 patients despite intensive diagnostic procedures. The follow-up of these patients showed a decrease of CEA level in 28 patients (80%), returning to normal range below 3.5 ng/ml in 20 patients (57%). There was an increase of CEA level in 5 (14.3%) and no change in two patients (5.7%). Except one patient who died of an unknown cause, none of the other patients developed malignancy in a period up to 34 months. We conclude that a single elevated serum CEA level does not justify further diagnostic procedures if clinical signs of a disease are absent. Patients with increasing CEA levels should be checked more intensively, because in some cases a previously undetectable malignant disease may become evident.