Diagnosis and screening

Serum CEA is elevated in about 65% of patients with distant metastases, in 44% of Dukes' stage C, about 25% of Dukes' stage B, and fewer than 5% of patients with Dukes' stage A colorectal cancer. CEA can also be elevated in:

♦ Severe benign liver disease

♦ Inflammatory lesions, especially of the gastrointestinal tract

♦ Collagen disease

♦ Renal impairment

A low incidence of high serum CEA levels in early disease and its poor specificity explain its lack of value in screening normal populations for colorectal cancer. A low sensitivity precludes it being useful for screening patients even in high-risk groups such as ulcerative colitis or familial polyposis coli.

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