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Enhancing Cancer Prediction Among People With Elevated CEA: A Novel Approach Using CEA Levels and Clinical Risk

Nithi Thinrungroj1, Sirikanya Wisetkupt1, Kanokporn Pinyopornpanish2,3

  • 1Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Journal of Primary Care & Community Health
|March 19, 2026
PubMed
Summary

Elevated Carcinoembryonic antigen (CEA) levels, when combined with a clinical risk score, significantly improve cancer prediction. This integrated approach aids in optimizing early cancer detection strategies for better patient outcomes.

Keywords:
cancercarcinoembryonic antigenclinical risk scorepredictionscreening

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Area of Science:

  • Oncology
  • Biomarker Research
  • Clinical Diagnostics

Background:

  • Carcinoembryonic antigen (CEA) is a widely used blood biomarker for cancer monitoring and prognosis.
  • Elevated CEA levels in routine check-ups often lead to non-specific investigations.
  • This study explored enhancing cancer prediction by integrating CEA with clinical risk assessment.

Purpose of the Study:

  • To investigate the integration of Carcinoembryonic antigen (CEA) levels with a clinical risk scoring system.
  • To enhance cancer prediction accuracy in individuals with elevated CEA levels.
  • To optimize early cancer detection strategies.

Main Methods:

  • Retrospective analysis of participants in general health check-up programs.
  • Inclusion of individuals with elevated CEA (≥5 ng/mL) and no prior cancer diagnosis.
  • Development and evaluation of a multivariable logistic regression-based risk scoring system using ROC analysis.

Main Results:

  • Out of 17,859 participants, 310 had elevated CEA, with 7.40% diagnosed with cancer (mainly colorectal).
  • The integrated approach (CEA + risk score) achieved an Area Under the ROC Curve of 0.918.
  • This significantly outperformed CEA levels alone (AUC 0.825) in cancer prediction.

Conclusions:

  • Combining CEA levels with clinical risk prediction shows significant promise for identifying cancer in individuals with elevated CEA.
  • This integrated method can refine early cancer detection efforts.
  • The approach has the potential to improve patient outcomes through earlier diagnosis.