Value of serial carcinoembryonic antigen determinations for early detection of recurrent cancer

Carcinoembryonic antigen (CEA) has been monitored at intervals of approximately three months in patients who had undergone potentially curative surgery for breast cancer, head and neck cancer, lung cancer, and colorectal cancer, but who were considered to be at high risk of recurrence. Monitoring of CEA in patients' serum was of no value for the early detection of tumour recurrence in either breast or head and neck cancer patients. It was of value for the early detection of lung cancer recurrence, but these patients were always beyond the scope of cure. In colorectal cancer patients, two-thirds of recurrences were heralded by a rising CEA, but only one of 15 patients had disease confined to local tissues which could be totally excised, although a further three patients had liver metastases which were apparently localized to one lobe of the liver. For colorectal cancer patients, serial CEA estimations are an effective method for the early diagnosis of recurrence, although this seldom translates into improved patient benefit.