Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort

Pin-Vieito, N. ; Iglesias, M.J. ; Remedios, D. ; Alvarez-Sanchez, V. ; Fernandez-Banares, F. ; Boadas, J. ; Martinez-Bauer, E. ; Campo, R. ; Bujanda, L. ; Ferrandez, A. (Universidad de Zaragoza) ; Pinol, V. ; Rodriguez-Alcalde, D. ; Menendez-Rodriguez, M. ; Garcia-Morales, N. ; Perez-Mosquera, C. ; Cubiella, J.

Resumen: We aimed to assess the risk of cancer in patients with abdominal symptoms after a complete colonoscopy without colorectal cancer (CRC), according to the carcinoembryonic antigen (CEA) concentration, as well as its diagnostic accuracy. For this purpose, we performed a post-hoc analysis within a cohort of 1431 patients from the COLONPREDICT study, prospectively designed to assess the fecal immunochemical test accuracy in detecting CRC. Over 36.5 +/- 8.4 months, cancer was detected in 115 (8%) patients. Patients with CEA values higher than 3 ng/mL revealed an increased risk of cancer (HR 2.0, 95% CI 1.3-3.1), CRC (HR 4.4, 95% CI 1.1-17.7) and non-gastrointestinal cancer (HR 1.7, 95% CI 1.0-2.8). A new malignancy was detected in 51 (3.6%) patients during the first year and three variables were independently associated: anemia (OR 2.8, 95% CI 1.3-5.8), rectal bleeding (OR 0.3, 95% CI 0.1-0.7) and CEA level >3 ng/mL (OR 3.4, 95% CI 1.7-7.1). However, CEA was increased only in 31.8% (95% CI, 16.4-52.7%) and 50% (95% CI, 25.4-74.6%) of patients with and without anemia, respectively, who would be diagnosed with cancer during the first year of follow-up. On the basis of this information, CEA should not be used to assist in the triage of patients presenting with lower bowel symptoms who have recently been ruled out a CRC.

Idioma: Inglés

DOI: 10.3390/diagnostics10121036

Año: 2020

Publicado en: Diagnostics 10, 12 (2020), 1036 [13 pp]
ISSN: 2075-4418

Factor impacto JCR: 3.706 (2020)

Categ. JCR: MEDICINE, GENERAL & INTERNAL rank: 45 / 167 = 0.269 (2020) - Q2 - T1

Factor impacto SCIMAGO: 0.622 - Clinical Biochemistry (Q3)

Financiación: info:eu-repo/grantAgreement/EUR/ISCII-ERDF/A way to make Europe
Financiación: info:eu-repo/grantAgreement/ES/ISCIII-ERDF-FSE/PI17-00837
Financiación: info:eu-repo/grantAgreement/ES/ISCIII-ESF/Investing in your future

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)