CEA should only be used for follow up of patients with histologically proven tumour and not for screening for cancer. CEA can be elevated in almost any advanced adenocarcinoma but is rarely elevated in localised cancer. It is elevated in a number of non-malignant conditions including chronic liver disease, Crohn’s disease, renal disease, emphysema and in healthy smokers.
Possible clinical indications for measurement are:
- Preoperatively to provide prognostic information, and to assess utility for postoperative surveillance.
- Surveillance following curative resection of colorectal cancer.
- Monitoring therapy for advanced colorectal cancer.
However, there is little evidence that monitoring patients leads to improved outcomes or improved quality of life.