CEA blood testing of questionable benefit to colorectal cancer surveillance - Tiffany Tsang

Research undertaken by Tiffany Tsang with support from Associate Professor Mark Thompson-Fawcett, Surgical Sciences
Lions Club of Dunedin South Scholar (Administered by Perpetual Guardian)

While carcinoembryonic antigen (CEA) blood testing leads to earlier detection of colorectal cancer recurrence, the survival likelihood is only mildly increased.

A new research project at Dunedin hospital aims to refine CEA testing guidelines for surveillance of patients after surgery for colorectal cancer. It is led by Mr Mark Thomson-Fawcett, Department of Surgical Sciences, and medical student Tiffany Tsang, as part of a summer research project funded by the Otago Medical Research Foundation.

CEA is a blood protein produced by colorectal tumours. It is tested every few months after surgery for colorectal cancer to check for recurrence of the cancer However, it is not always raised, and can be raised by non-cancerous conditions. This leads to missed diagnoses or unnecessary extra investigations.

We collected data on 350 stage II and III colorectal cancer patients who started surveillance between 2012 and 2016. Data collected included age, sex, ethnicity, tumour stage, histological details and smoking status. Investigations examined included CEA results and resulting CT scan reports.

So far, 136 patients had high CEA at any point during follow up. Only 34 of these patients had recurrent colorectal cancer, out of a total of 53 recurrences. High CEA recurrences were detected 3.3 months before normal CEA patients. They were 0.52 times as likely to receive surgery for recurrence, and 1.2 times as likely to survive.

At present, CEA testing appears to have had little additional benefit to routine surveillance.

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