Blood-borne biomarkers for early detection of colorectal cancer (CRC) could markedly increase screening uptake. The aim of this study was to evaluate serum carcinoembryonic antigen (CEA), CYFRA21-1 and CA125 for the early detection of CRC in an asymptomatic cohort

A Gentry-Maharaj

A Ryan

AH Chevinsky

B Levin

D Rastel

D S Thomas

DA Johnson

DF Ransohoff

DP Taylor

E Lindholm

E-O Fourkala

EO Fourkala

EP Whitlock

GY Locker

I Jacobs

J F Timms

JC Alexander

JD Hardcastle

JE Allison

JH Lee

JH Wanebo

JJ Ladd

JK Lee

JS Mandel

JV Selby

K Robb

L Buchen

L Guittet

MD Gill

MJ Duffy

MS Pepe

N Wild

O Holme

O Kronborg

R Goslin

R Gunu

R Molina

R Palmqvist

RE Schoen

RF Logan

S Apostolidou

S Hammarstrom

SR Cairns

T Raginel

TF Imperiale

TR Church

U Menon

V Barak

W Alderton

WS Atkin

PubMed

Crossref

British Journal of Cancer

Evaluation of serum CEA, CYFRA21-1 and CA125 for the early detection of colorectal cancer using longitudinal preclinical samples

Background: Blood-borne biomarkers for early detection of colorectal cancer (CRC) could markedly increase screening uptake. The aim of this study was to evaluate serum carcinoembryonic antigen (CEA), CYFRA21-1 and CA125 for the early detection of CRC in an asymptomatic cohort. Methods: This nested case–control study within UKCTOCS used 381 serial serum samples from 40 women subsequently diagnosed with CRC, 20 women subsequently diagnosed with benign disease and 40 matched non-cancer controls with three to four samples per subject taken annually up to 4 years before diagnosis. CEA, CYFRA21-1 and CA125 were measured using validated assays and performance of markers evaluated for different pre-diagnosis time groups. Results: CEA levels increased towards diagnosis in a third of all cases (half of late-stage cases), whereas longitudinal profiles were static in both benign and non-cancer controls. At a threshold of45 ngml  1 the sensitivities for detecting CRC up to 1 and 4 years before clinical presentation were 25 % and 13%, respectively, at 95 % specificity. At a threshold of42.5 ngml  1, sensitivities were 57.5 % and 38.4%, respectively, with specificities of 81 % and 83.5%. CYFRA21-1 and CA125 had no utility as screening markers and did not enhance CEA performance when used in combination. CEA gave average lead times of 17–24 months for test-positive cases. Conclusions: CEA is elevated in a significant proportion of individuals with preclinical CRC, but would not be useful alone as a screening tool. This work sets a baseline from which to develop panels of biomarkers which combine CEA for improved earl

Evaluation of serum CEA, CYFRA21-1 and CA125 for the early detection of colorectal cancer using longitudinal preclinical samples

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