II. Indications

  1. Stage II or III (Duke B1-C1) Colon Cancer monitoring
  2. Do not use to screen for Colon Cancer or other cancer

III. Interpretation

  1. Normal
    1. Non-smokers: <2.5 mg/ml
    2. Smokers: <5 ng/ml
  2. Increased
    1. Benign disease unlikely if >10 ng/ml
    2. Distant metastasis most likely if >100 ng/ml

IV. Efficacy

  1. Not specific
    1. Seen in other adenocarcinoma (see below)
  2. Sensitivity varies by tumor stage and differentiation
    1. CEA not increased in poorly differentiated tumors
    2. Increased in <25% of Duke A or B stage Colon Cancer
    3. Increased in 50% with Duke C stage Colon Cancer
    4. Increased in 75% of Duke D stage Colon Cancer

VI. Protocol for monitoring after Colorectal Cancer resection

  1. Repeat CEA level q2-3 months for 2 years

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