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Also known as: CA 199, Carbohydrate Antigen 19-9
The CA 19-9 test contains 1 test with 1 biomarker.
Brief Description: The CA 19-9 test is a laboratory test that measures the level of a specific tumor marker called carbohydrate antigen 19-9 (CA 19-9) in the blood. CA 19-9 is a glycoprotein that is often elevated in certain types of cancer, particularly cancers of the gastrointestinal tract, including pancreatic, colorectal, and gastric cancers.
Also Known As: Carbohydrate Antigen (CA) 19-9 Test, Cancer Antigen 19-9 Test, Cancer Antigen (CA) 19-9, Carbohydrate Antigen 19-9 Test
Collection Method: Blood Draw
Specimen Type: Serum
Test Preparation: No preparation required
A CA 19-9 test may be ordered in the following situations:
Cancer Diagnosis: The test may be ordered when a healthcare provider suspects the presence of certain types of cancer, such as pancreatic, colorectal, or gastric cancer. CA 19-9 levels can be elevated in these cancers, and the test helps in the diagnostic process.
Monitoring Cancer Treatment: For individuals already diagnosed with cancer, the CA 19-9 test may be used to monitor the effectiveness of treatment and assess disease progression. Serial measurements of CA 19-9 levels can provide information on treatment response and help guide further management decisions.
The protein cancer antigen 19-9 is found on the surface of some cancer cells. CA 19-9 does not cause cancer; rather, it is emitted by tumor cells and can be discovered in blood and other bodily fluids by laboratory tests. The level of CA19-9 is measured in this test.
Because CA 19-9 can be tested in the blood, it can be used as a tumor marker to track the progression of cancer. CA 19-9 levels are high in 70% to 95% of persons with advanced pancreatic cancer.
CA 19-9 levels may also be elevated in cancers of the gallbladder and bile ducts, colorectal cancer, gastric cancers, ovarian cancer, lung cancer, liver cancer, pancreatitis, thyroid disease, and liver disease, among other cancers, conditions, and diseases. CA 19-9 is found in trace levels in the blood of healthy humans. CA 19-9 cannot be utilized for screening or diagnosis by itself because it is not specific for pancreatic cancer.
When a CA 19-9 test is ordered, it's typically part of a broader evaluation for cancer diagnosis, monitoring, or assessing the risk of recurrence. Here are some tests commonly ordered alongside it:
CEA (Carcinoembryonic Antigen) Test:
Bilirubin and Alkaline Phosphatase Tests:
These tests, when ordered alongside a CA 19-9 test, provide a comprehensive view of a patient’s cancer status and are essential in the diagnosis, monitoring, and management of pancreatic and other gastrointestinal cancers. The specific combination of tests will depend on the type of cancer suspected or diagnosed, the stage, the treatment being received, and the patient’s overall health.
A CA 19-9 test may be required in the following conditions or situations:
Pancreatic Cancer: CA 19-9 is commonly associated with pancreatic cancer, and the test may be ordered to aid in the diagnosis, monitor treatment response, and assess disease progression in individuals with pancreatic cancer.
Colorectal Cancer: CA 19-9 levels can be elevated in colorectal cancer, although it is less specific for this cancer type compared to pancreatic cancer. The test may be used in conjunction with other diagnostic tools for colorectal cancer evaluation and management.
Gastric Cancer: Elevated CA 19-9 levels can also be seen in gastric (stomach) cancer. The test may be ordered to assist in the diagnosis and monitoring of individuals with gastric cancer.
Healthcare providers use the results of a CA 19-9 test in the following ways:
Diagnosis: Elevated CA 19-9 levels, in conjunction with other clinical findings and imaging studies, may support the diagnosis of pancreatic, colorectal, or gastric cancer. However, it is important to note that CA 19-9 levels can also be elevated in noncancerous conditions.
Treatment Monitoring: Serial measurements of CA 19-9 levels during cancer treatment help healthcare providers assess treatment response and disease progression. A decrease in CA 19-9 levels may indicate a positive response to treatment, while increasing or persistently high levels may suggest tumor growth or resistance to therapy.
Prognosis and Follow-up: CA 19-9 levels can provide prognostic information in certain cancers. High initial levels or persistently elevated levels after treatment may be associated with a worse prognosis. Periodic monitoring of CA 19-9 levels during follow-up visits can help detect cancer recurrence or progression.
It is important to note that while the CA 19-9 test is a valuable tool in cancer management, it is not specific to a particular cancer type, and elevated levels can be seen in noncancerous conditions as well. Therefore, the test results should be interpreted in conjunction with clinical findings, imaging studies, and other diagnostic tests to make accurate assessments and guide appropriate patient care.
Healthy persons have low levels of CA 19-9, although numerous illnesses that affect the liver or pancreas can induce transitory spikes.
People with pancreatic cancer, other malignancies, and a variety of other diseases and ailments may have moderate to high levels. CA 19-9 levels are higher in cancers of the exocrine pancreas. This cancer develops in the tissues that manufacture food-digesting enzymes, as well as in the ducts that transport those enzymes to the small intestine. This kind of pancreatic cancer accounts for approximately 95% of all pancreatic cancers.
CA 19-9 levels that rise and then diminish over time may indicate that the treatment is functioning and/or that the malignancy was successfully removed during surgery. Levels that stay high or rise over time could suggest that treatment isn't working and/or that the cancer is reoccurring.
What is the CA 19-9 test?
The CA 19-9 test is a blood test that measures the level of CA 19-9 antigen, a protein that is often higher in people with certain types of cancer, especially pancreatic cancer.
Why is the CA 19-9 test ordered?
The CA 19-9 test may be ordered when a person has symptoms suggestive of pancreatic cancer, such as abdominal pain, jaundice, and weight loss. It can also be used to monitor treatment in those diagnosed with pancreatic cancer.
What does a high CA 19-9 test result mean?
A high CA 19-9 level may suggest the presence of pancreatic cancer, but it can also be elevated in other cancers, as well as in non-cancerous conditions like gallstones, pancreatitis, cirrhosis, and cystic fibrosis.
What does a low CA 19-9 test result mean?
A low or normal CA 19-9 level is typically not indicative of any specific condition. It's important to note that not all individuals with pancreatic cancer will have elevated CA 19-9 levels.
What factors can affect CA 19-9 test results?
Various factors can affect CA 19-9 levels. Certain non-cancerous conditions, such as liver disease, gallstones, or pancreatitis can raise CA 19-9 levels. In addition, not all people have the ability to produce the CA 19-9 antigen, which can lead to lower test results.
Can the CA 19-9 test diagnose diseases other than pancreatic cancer?
While the CA 19-9 test is most commonly associated with pancreatic cancer, it can't definitively diagnose any disease. Elevated levels can occur in other cancers, like colorectal, stomach, and bile duct cancers, and in non-cancerous conditions.
How is the CA 19-9 test used in managing pancreatic cancer treatment?
Once pancreatic cancer is diagnosed, the CA 19-9 test can be used to monitor the effectiveness of treatment. If levels decrease during treatment, it usually indicates that the treatment is working.
Can the CA 19-9 test be used to detect cancer recurrence?
Yes, after treatment for pancreatic cancer, rising CA 19-9 levels might suggest recurrence of the disease. However, other tests and investigations are usually needed to confirm this.
Why isn't the CA 19-9 test recommended as a general screening test for pancreatic cancer?
The CA 19-9 test is not recommended as a general screening test because not all pancreatic cancers produce CA 19-9, and the antigen can also be elevated in other conditions, making it a non-specific marker.
Can the CA 19-9 test determine the stage of pancreatic cancer?
Although higher levels of CA 19-9 are often associated with more advanced disease, the test alone cannot determine the stage of pancreatic cancer. Imaging studies and possibly biopsies are needed for accurate staging.
Can the CA 19-9 test predict prognosis in pancreatic cancer?
Elevated levels of CA 19-9 before treatment can indicate a worse prognosis in pancreatic cancer. However, many factors influence prognosis and CA 19-9 is just one piece of the overall picture.
How does the CA 19-9 test relate to other cancer markers?
CA 19-9 is one of several tumor markers that can be elevated in cancer. Others include CA-125 for ovarian cancer, PSA for prostate cancer, and CEA for colorectal cancer. These markers can sometimes be used in combination to increase diagnostic accuracy.
How often should the CA 19-9 test be performed when monitoring pancreatic cancer?
The frequency depends on the clinical situation and your doctor's recommendation. Typically, it is checked before starting treatment, and then periodically during and after treatment to monitor response.
Why is the CA 19-9 test not always reliable for pancreatic cancer diagnosis?
The CA 19-9 test is not always reliable for diagnosis because not all pancreatic cancers produce CA 19-9. Furthermore, some people cannot produce the antigen due to their genetic makeup, and the antigen can also be elevated in other cancers and non-cancerous conditions.
How does the CA 19-9 test relate to the overall management of pancreatic cancer?
The CA 19-9 test plays a role in the overall management of pancreatic cancer, primarily as a tool for monitoring treatment response and detecting recurrence. However, decisions about treatment are based on many factors, not just CA 19-9 levels.
How does the CA 19-9 test relate to other tests in pancreatic cancer diagnosis?
The CA 19-9 test is often used in conjunction with imaging tests and biopsies in the diagnosis and management of pancreatic cancer. It cannot replace these tests, but it can provide additional information.
Can the CA 19-9 test replace a biopsy for pancreatic cancer diagnosis?
No, the CA 19-9 test cannot replace a biopsy. While elevated CA 19-9 levels can suggest the possibility of pancreatic cancer, a definitive diagnosis requires a biopsy.
Can the CA 19-9 test differentiate between different types of pancreatic tumors?
No, the CA 19-9 test does not differentiate between different types of pancreatic tumors. It can only indicate the possible presence of a tumor, but not its specific type.
Can the CA 19-9 test predict response to specific drugs in pancreatic cancer?
The CA 19-9 test is primarily used to monitor overall treatment response, not to predict response to specific drugs. However, decreasing levels during treatment often indicate that the treatment is working.
Why might a person without cancer have an elevated CA 19-9 test result?
Several non-cancerous conditions, such as liver disease, gallstones, pancreatitis, and cystic fibrosis, can cause elevated CA 19-9 levels.
How does the CA 19-9 test compare to other tests in terms of accuracy for pancreatic cancer?
The CA 19-9 test is a useful tool, but it is not 100% accurate for diagnosing pancreatic cancer because not all pancreatic cancers produce CA 19-9. Its accuracy is increased when used in combination with other tests like imaging studies and biopsies.
Can a person's genetic makeup affect the CA 19-9 test?
Yes, about 5-10% of people lack the ability to produce the CA 19-9 antigen due to their genetic makeup. These people will not have elevated CA 19-9 levels even if they have pancreatic cancer.
Can the CA 19-9 test be used to monitor conditions other than pancreatic cancer?
Yes, the CA 19-9 test can also be used to monitor other conditions that cause elevated CA 19-9 levels, such as liver disease, gallstones, and pancreatitis. However, it's primarily used in the context of cancer.
What is the relevance of the CA 19-9 test in colorectal cancer?
The CA 19-9 test can sometimes be used in the management of colorectal cancer, as CA 19-9 levels can be elevated in this condition. It might be used alongside another marker, carcinoembryonic antigen (CEA), to monitor treatment response or detect recurrence.
Can the CA 19-9 test be used in the management of gallbladder cancer?
The CA 19-9 test can be used in the management of gallbladder cancer as CA 19-9 levels can be elevated in this condition. It can be used to monitor treatment response and to detect recurrence. However, as with other cancers, it cannot definitively diagnose gallbladder cancer.
We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.