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Also known as: Carcinoembryonic Antigen


The CEA test measures the level of carcinoembryonic antigen (CEA) in the blood. CEA is a protein normally found in the tissue of a developing baby in the womb. The blood level of this protein disappears or becomes very low after birth. In adults, an abnormal level of CEA may be a sign of cancer.
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The CEA test contains 1 test with 1 biomarker.

Brief Description: The CEA (carcinoembryonic antigen) test is a blood test that measures the levels of CEA, a protein present in certain cells, in the bloodstream. CEA is not normally found in the blood of healthy individuals, but it can be elevated in certain types of cancer and other conditions. The test is primarily used as a tumor marker to aid in the diagnosis, treatment, and monitoring of certain cancers.

Also Known As: Carcinoembryonic antigen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a CEA test ordered?

A CEA test may be ordered in the following situations:

  1. Cancer Diagnosis: The test may be ordered if a specific type of cancer is suspected based on symptoms, imaging studies, or other diagnostic tests. Elevated CEA levels can support the diagnosis of certain cancers, particularly colorectal, lung, pancreatic, and breast cancers.

  2. Cancer Staging and Monitoring: In individuals already diagnosed with cancer, the CEA test can be used to assess the extent (stage) of the disease and monitor treatment effectiveness. Serial CEA measurements over time can help track changes in CEA levels, providing information about response to therapy and disease progression.

  3. Evaluation of Recurrence: For individuals with a history of cancer, a CEA test may be ordered to detect early signs of recurrence or metastasis. Rising CEA levels over time may indicate a recurrence, even before symptoms or other imaging studies reveal the presence of cancer.

What does a CEA blood test check for?

Carcinoembryonic antigen is a protein found in the developing tissues of a fetus. It drops to a very low level by the time a baby is delivered. CEA is generally seen in extremely low amounts in the blood of people, but it can be raised in cancer patients. This test examines the quantity of CEA in the blood to aid in the evaluation of cancer patients.

CEA is a tumor indicator. CEA was once assumed to be a particular marker for colon cancer, however subsequent research has revealed that an elevation in CEA can be detected in a variety of malignancies. Non-cancer disorders such as inflammation, cirrhosis, peptic ulcer, ulcerative colitis, rectal polyps, emphysema, and benign breast disease, as well as smokers, can cause an increase in CEA. As a result, it is ineffective as a general cancer screening tool, although it does play a role in assessing cancer therapy response. An initial CEA baseline test may be performed after a person has been diagnosed with cancer. If this level is raised, serial CEA testing may be used to track the cancer's progress as the patient receives treatment.

Lab tests often ordered with a CEA test:

When a CEA test is ordered, it's typically part of a broader evaluation of cancer or its treatment. Here are some tests commonly ordered alongside it:

  1. Complete Blood Count (CBC):

    • Purpose: Provides a broad picture of overall blood health, including red and white blood cells and platelets.
    • Why Is It Ordered: To monitor overall health, detect anemia, and evaluate the patient’s immune status, which can be crucial in the context of cancer treatment.
  2. Liver Function Test:

    • Purpose: To assess liver health.
    • Why Is It Ordered: To evaluate liver function and detect liver metastases, which are common in colorectal and other cancers where CEA is used as a marker.
  3. CA 19-9:

    • Purpose: A tumor marker that can be elevated in pancreatic and gastrointestinal cancers.
    • Why Is It Ordered: To monitor or detect certain gastrointestinal cancers, particularly in conjunction with CEA for gastrointestinal malignancies.
  4. Kidney Function Test:

    • Purpose: To evaluate kidney function.
    • Why Is It Ordered: To assess the impact of cancer or its treatment on kidney function and to monitor overall health.
  5. Lactate Dehydrogenase (LDH):

    • Purpose: An enzyme that can be elevated in the presence of tissue damage, including from cancer.
    • Why Is It Ordered: As a general marker of cancer proliferation and tissue damage.

These tests, when ordered alongside a CEA test, provide a comprehensive view of a patient’s cancer status, monitor the effectiveness of treatment, and check for signs of recurrence or metastasis. The specific combination of tests will depend on the type of cancer, the stage, the treatment being received, and the patient’s overall health.

Conditions where a CEA test is recommended:

A CEA test is particularly useful in the following conditions or diseases:

  1. Colorectal Cancer: CEA testing is commonly used in the diagnosis, staging, and monitoring of colorectal cancer. Elevated CEA levels are associated with advanced disease, lymph node involvement, and increased risk of recurrence.

  2. Lung Cancer: CEA levels may be elevated in certain types of lung cancer, especially non-small cell lung cancer. The test can aid in diagnosis, staging, and monitoring treatment response.

  3. Pancreatic Cancer: CEA levels may be elevated in pancreatic cancer, although it is not a highly specific marker for this disease. Combined with other diagnostic tests, CEA testing can provide additional information about the presence and progression of pancreatic cancer.

  4. Breast Cancer: In some cases of breast cancer, particularly advanced or metastatic breast cancer, CEA levels may be elevated. Serial CEA measurements can help monitor treatment response and disease progression.

How does my healthcare provider use a CEA test?

Health care providers use the results of a CEA test to:

  1. Support Cancer Diagnosis: Elevated CEA levels, in conjunction with other clinical findings, imaging studies, and biopsy results, can provide supporting evidence for the diagnosis of certain cancers.

  2. Monitor Treatment Response: Serial CEA measurements help assess the effectiveness of cancer treatment. Decreasing or stable CEA levels suggest a positive response to therapy, while rising levels may indicate disease progression or recurrence.

  3. Detect Recurrence: In individuals with a history of cancer, rising CEA levels may be an early indicator of cancer recurrence or metastasis, prompting further investigation and intervention.

It is important to note that while elevated CEA levels can be associated with certain cancers, this test is not specific to cancer and can be influenced by other factors, such as smoking, inflammation, and certain non-cancerous conditions. Therefore, CEA results should always be interpreted in conjunction with other clinical information and additional diagnostic tests.

What do my CEA test results mean?

Monitoring treatment and recurrence: CEA levels that are first raised but later return to normal following treatment indicate that the cancer has been successfully treated. The first symptom of tumor recurrence is frequently a progressively rising CEA level.

Staging: People with smaller and early-stage tumors are more likely to have a normal or slightly raised CEA score on initial testing. A high CEA value is more probable in people with larger tumors, later-stage cancer, or cancers that have disseminated throughout the body.

Testing for metastasis: If CEA is found in a bodily fluid other than blood, the cancer has most likely migrated to that part of the body. If CEA is found in CSF fluid, for example, it could suggest that cancer has spread to the central nervous system.

Because not all malignancies produce CEA, it's possible to have cancer and a normal CEA at the same time. The test will be useless as a surveillance tool if a malignancy does not produce CEA.

Most Common Questions About the CEA test?

Understanding the CEA Test and Its Purpose

What is the CEA test?

The CEA (Carcinoembryonic Antigen) test is a blood test used to monitor certain types of cancers, especially cancer of the colon and rectum. It measures the amount of CEA protein in the blood, which can increase when cancer is present.

Why is the CEA test performed?

The CEA test is primarily used to monitor treatment in people with certain types of cancers, particularly colorectal cancer. It can also be used to check if cancer has returned after treatment. It's not typically used for initial cancer screening because many non-cancerous conditions can also raise CEA levels.

Who should get a CEA test?

Individuals diagnosed with conditions that can elevate CEA levels, such as colorectal cancer or other cancers like breast, lung, liver, pancreas, stomach, or ovary, may get a CEA test. It's also used for those undergoing treatment for these cancers or monitoring for recurrence.

Interpreting Test Results

What do the results of a CEA test mean?

A higher than normal level of CEA can indicate that cancer may be present, cancer treatment is not working, or cancer has returned after treatment. However, high CEA levels can also be due to other conditions, like inflammation, infection, liver disease, or smoking. Therefore, the results need to be interpreted along with other tests and clinical information.

What is considered a normal CEA level?

CEA levels may vary depending on the lab, but typically, a non-smoker should have a CEA level less than 2.5 nanograms per milliliter (ng/mL), and a smoker's CEA level should be less than 5.0 ng/mL.

Understanding the Implications and Health Impact

What health implications are linked to the CEA test results?

High CEA levels could suggest that cancer is present, has returned, or that cancer treatment may not be working. However, many benign conditions can also raise CEA levels, so high levels are not definitive proof of cancer.

Does a high CEA level mean I definitely have cancer?

No, a high CEA level does not conclusively indicate cancer. Many non-cancerous conditions can raise CEA levels, including smoking, liver disease, inflammatory bowel disease, lung infections, and more.

Risk Factors, Prevention, and Treatment

Can certain conditions or lifestyle factors affect the results of a CEA test?

Yes, conditions like liver disease, inflammatory bowel disease, or lung infections can raise CEA levels. Lifestyle factors, particularly smoking, can also increase CEA levels.

How are the results of a CEA test used to guide cancer treatment?

In people with cancer, particularly colorectal cancer, the CEA test can help guide treatment decisions. If CEA levels drop, it suggests the treatment is working. If CEA levels rise, it may indicate the cancer is not responding to treatment, or it has recurred after treatment.

Can the risk of high CEA levels be reduced?

There's no direct way to reduce CEA levels as they're typically a symptom of an underlying condition. Treating the underlying condition, whether it's cancer or a non-cancerous disease, can help lower CEA levels. If the elevated CEA is due to smoking, quitting can help reduce levels.

The CEA Test in Medical Practice

How does the CEA test assist in the diagnosis of cancer?

While the CEA test is not used for initial cancer diagnosis due to its lack of specificity, it can contribute to diagnosing the return of cancer in individuals who had elevated CEA levels with their initial cancer.

How often should I get a CEA test if I have been diagnosed with cancer?

The frequency of the CEA test will depend on the type and stage of cancer, as well as whether you're currently in treatment or in remission. Your healthcare provider will recommend a testing schedule based on your specific situation.

Does the CEA test have any limitations?

Yes, the CEA test has significant limitations. It's not highly specific or sensitive to cancer, meaning it can show elevated levels in non-cancerous conditions and normal levels in some people with cancer. Therefore, it's not used for cancer screening in the general population.

Can the CEA test be used for cancers other than colorectal?

While it's most commonly used for colorectal cancer, CEA levels may also be elevated in other types of cancer, such as breast, lung, liver, pancreas, stomach, or ovarian cancer. However, its use in these cancers is less established and often not as informative.

Can the CEA test be used to determine the stage of cancer?

CEA levels can sometimes correlate with the extent of the disease in colorectal cancer, with higher levels often seen in more advanced disease. However, it's not used alone to stage cancer.

Further Insights into the CEA Test

Why is the CEA test not suitable for cancer screening in the general population?

Given that many non-cancerous conditions can raise CEA levels and some people with cancer may not have elevated CEA levels, the test lacks the necessary sensitivity and specificity for cancer screening in the general population.

Why is the CEA test used more commonly in colorectal cancer?

CEA was first identified in colorectal cancer cells, and many people with this type of cancer have elevated CEA levels. Therefore, it's often used to monitor treatment and check for recurrence in colorectal cancer.

How does the CEA test help in determining prognosis in cancer patients?

In some types of cancer, particularly colorectal cancer, higher pre-treatment CEA levels can suggest a poorer prognosis. Additionally, if CEA levels do not drop after treatment, it may suggest that not all the cancer was removed or treated.

Can changes in CEA levels suggest specific types of treatment?

Changes in CEA levels can help indicate whether a certain treatment is working, but they don't guide the choice of specific treatments.

Can the CEA test replace other diagnostic procedures for cancer?

No, the CEA test cannot replace other diagnostic procedures for cancer. While it can help monitor the effectiveness of treatment and detect recurrence in certain cancers, it cannot conclusively diagnose cancer.

Is there an optimal time to perform the CEA test?

There's no general optimal time. It's usually done at diagnosis to establish a baseline, and then at regular intervals during and after treatment. The frequency is usually determined by the doctor based on the patient's specific circumstances.

Can the CEA test be used in conjunction with other tests?

Yes, the CEA test is often used in conjunction with other tests such as imaging studies and other blood tests to monitor cancer treatment and check for recurrence.

Is there a direct correlation between the CEA level and the size of the tumor?

There can be a correlation, but it's not consistent. Some large tumors may produce little CEA, and some small tumors may produce a lot. The correlation between CEA levels and tumor size is not reliable enough to make definitive conclusions about tumor size based on CEA levels alone.

How does inflammation or infection affect CEA test results?

Inflammation or infection can cause CEA levels to rise even in the absence of cancer. This is one reason why the CEA test is not used for cancer screening in the general population.

Can the CEA test detect cancer recurrence?

Yes, in individuals who had elevated CEA levels with their initial cancer, a rise in CEA levels after treatment can suggest the cancer has returned. However, other tests are usually needed to confirm recurrence.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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