Characteristics and Outcomes of Colorectal Cancer in Patients with Elevated Carcinoembryonic Antigen (CEA) Levels

Aims Carcinoembryonic Antigen (CEA) is used as a tumor marker in Colorectal Cancer (CRC) patients. We aimed to investigate the frequency of high CEA (more than 5 ng/ml) and the clinical characteristics and outcomes of CRC patients with high CEA compared to those with low CEA.

Methods We included patients with confirmed CRC and had a CEA at the time of CRC diagnosis. Data regarding demographics, indications, comorbidities, endoscopic data, and laboratories were collected. A CEA level of 5 ng/ml or more was considered as a high CEA level.

Results In the present study, 2519 patients were included, 855 of them had a high CEA level, and 1664 had a low level of CEA. Patients with high CEA reported more abdominal pain (44% vs. 25.6%, p<0.001) and weight loss (14.4% vs. 8.1%, p<0.001) as presenting symptoms. Patients with elevated CEA levels had significantly higher mortality (63.6% vs. 39.1%, p<0.001) and were more likely to present with Stage IV disease (44.8% vs. 9.7%, p<0.001). In multivariate analysis, abdominal pain (OR 1.555, 95%CI,1.279-1.891, p<0.001), Arab ethnicity (OR 1.528,1.035-2.255, p=0.033) Diabetes Mellitus (1.287, 1.056-1.569, p<0.001), and stage IV (4.970, 3.900-6.335, p<0.001) were found to be significant predictors of having high CEA.

Conclusions The study demonstrated high CEA levels are associated with worse advanced disease and worse outcomes. Patients presenting with certain factors should be considered at higher risk for aggressive or advanced colorectal cancer

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025