Authors (including presenting author) :
Yip Chun Kong, Chan Yin Hang, Yiu Chung Ting, Liang Jun
Affiliation :
Department of Family Medicine, Tuen Mun Hospital, New Teritories West Cluster
Introduction :
Colorectal cancer (CRC) is the most common cancer in Hong Kong. Carcinoembryonic antigen (CEA) is known to be a tumor marker for colorectal cancer but is neither specific or sensitive. Current evidence suggests against use of CEA as a screening or diagnostic tools for colorectal cancer. However, in case a CEA was checked, should we consider patient with elevated CEA in high risk and warrant earlier attention?
Objectives :
To evaluate if patients in primary care clinics with elevated CEA are of higher risk in developing colorectal cancer.
Methodology :
All patients with CEA checked in Tin Shui Wai Community Health Centre, Yan Oi Clinic and Tin Shui Wai Clinic from 09/2012 to 08/2015 are searched via CDARS. Cases are reviewed by CMS for their CEA level and if they develop cancer of colon at end of 2019.
Result & Outcome :
Total of 488 cases were found. 63 patients with elevated CEA. 425 patients wiht normal CEA. For patient with elevated CEA, mean age was 65, male to female ratio 1.3:1. Median CEA level was 6.7. 43 endoscope done with 10 cases of CRC found (16%), 1 case diagnosed Cancer of pancreas, 1 case diagnosed with Cancer of ovary and 3 cases were diagnosed Cancer of Lung. For Patients with normal CEA, average age was 57, male to female ratio 0.79: 1. 125 endoscope done with 6 cases of CRC found (1.4%). 1 case was diagnosed cancer of pancreas.
This study is retrospective, unblinded and uncontrolled. Outcome is only review by CMS record. However, the figure showing the risk of suffering CRC is 10 times higher in elevated CEA group. Although it is not specific to CRC alone, however the result do implies it represent much higher risk of CRC and other type of cancer. I would not recommend CEA checking as a diagnostic or screening tools, but in case it is checked for whatever reason, it prompt earlier attention than normal CEA cases. Higher quality local study should be done to evaluate its value in Asian population.
