September 7, 2013

Matters the Markers Maketh – Carcinoembryonic Antigen (CEA)

Cancer Marker CEA


Health screening is a necessary chore many of us we do partake, whether it is part of an annual company ritual, or the healthy conscience part of us.  While most will complete the rite with an assurance of health in the coming year, some will receive markers that signify a possibility of further tests to come.

There is certainly much evidence that early detection of cancers can save lives, especially when early stages of cancer are silent and asymptomatic.  Much of gastrointestinal cancers fall into this category, and late detection (at the onset of signs and symptoms) often mean late and advanced disease.  This explains the basis for colorectal cancer screening, as all colon cancer arises from diminutive and silently-growing polyps.

Carcinoembryonic antigen (CEA) is a tumour marker that is popularly tested as a tumour screening blood panel in health screening packages, for the early detection of colorectal cancer.  CEA is a protein that can be detected in the blood, and is probably best used in the context of a known cancer, where a decrease in its levels following cancer treatment signify successful eradication, and the converse denotes recurrence.  However, its use has been extended to health screening, with the ensuing surgical consultations in the event of elevated values.

CEA is present in normal cells, but elevated levels are found in certain cancers.  The following conditions can possibly lead to an elevated CEA level:


–       colorectal cancer

–       stomach cancer

–       pancreatic cancer

–       breast cancer

–       lung cancer

Non-cancerous conditions

–       liver disease

–       chronic kidney disease

–       respiratory diseases

–       smoking


An elevated CEA level, therefore, does not equate cancer.  Unfortunately, a normal CEA level does not also equate no cancer.  It is estimated that only 25% of patients with confined colorectal cancer have an elevated CEA level.  These levels rise to 50% in the presence of lymph node spread, and 75% in the context of distant spread.

While its use in cancer screening remains controversial, in a local study of 217 asymptomatic patients presenting with an elevated CEA level, up to 7.4% were subsequently found to have a cancer on follow-up.  Therefore, abnormal blood CEA levels should probably be investigated and followed-up with the intention of excluding cancer.


To find out more on cancer screening and prevention, contact the Clinic for Digestive Surgery at +65 6570 2702 to speak to our Clinic Nurse.  Alternatively, drop us an email at, or fill up the enquiry form at  We will attend to you at the soonest opportunity.

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