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

Gastroenterology Department, Complexo Hospitalario Universitario de Ourense, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 32005 Ourense, Spain

Instituto de Investigación Biomedica Galicia Sur, 32005 Ourense, Spain

Department of Biochemistry, Genetics and Immunology, Faculty of Biology, University of Vigo, 36200 Vigo, Spain

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Gastroenterology Department, Complejo Hospitalario de Pontevedra, 36001 Pontevedra, Spain

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Gastroenterology Department, Hospital Universitari Mútua de Terrassa, CIBERehd, 08221 Terrassa, Spain

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Gastroenterology Department, ConsorciSanitari de Terrassa, 08221 Terrassa, Spain

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Gastroenterology Department, Hospital de Sabadell, Corporació Sanitàriai Universitària Parc Taulí, 08208 Sabadell, Spain

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Donostia Hospital, Biodonostia Institute, University of the Basque Country UPV/EHU, CIBERehd, 20010 San Sebastian, Spain

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Servicio de Aparato Digestivo, Hospital Clínico Universitario, IIS Aragón, University of Zaragoza, CIBERehd, 50009 Zaragoza, Spain

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Gastroenterology Department, Hospital Dr. Josep Trueta, 17007 Girona, Spain

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Digestive Disease Section, Hospital Universitario de Móstoles, 28935 Madrid, Spain

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Lavadores Primary Care Health Centre, Área de Saúde de Vigo, Pontevedra, 36214 Vigo, Spain

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Gastroenterology Department, Complexo Hospitalario Universitario Vigo, Pontevedra, 36001 Vigo, Spain

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Diagnostics 2020, 10(12), 1036; https://doi.org/10.3390/diagnostics10121036

Received: 6 October 2020 / Revised: 20 November 2020 / Accepted: 1 December 2020 / Published: 2 December 2020

(This article belongs to the Special Issue Novel Approaches in the Diagnosis of Primary and Secondary Disease within Colorectal Cancer)

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Abstract

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. View Full-Text

Keywords: biochemical diagnosis; carcinoembryonic antigen; colonoscopy; early cancer; gastrointestinal cancer; symptoms; tumor biomarkers

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Pin-Vieito, N.; Iglesias, M.J.; Remedios, D.; Álvarez-Sánchez, V.; Fernández-Bañares, F.; Boadas, J.; Martínez-Bauer, E.; Campo, R.; Bujanda, L.; Ferrández, Á.; Piñol, V.; Rodríguez-Alcalde, D.; Menéndez-Rodríguez, M.; García-Morales, N.; Pérez-Mosquera, C.; Cubiella, J. Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort. Diagnostics 2020, 10, 1036. https://doi.org/10.3390/diagnostics10121036

AMA Style

Pin-Vieito N, Iglesias MJ, Remedios D, Álvarez-Sánchez V, Fernández-Bañares F, Boadas J, Martínez-Bauer E, Campo R, Bujanda L, Ferrández Á, Piñol V, Rodríguez-Alcalde D, Menéndez-Rodríguez M, García-Morales N, Pérez-Mosquera C, Cubiella J. Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort. Diagnostics. 2020; 10(12):1036. https://doi.org/10.3390/diagnostics10121036

Chicago/Turabian Style

Pin-Vieito, Noel, María José Iglesias, David Remedios, Victoria Álvarez-Sánchez, Fernando Fernández-Bañares, Jaume Boadas, Eva Martínez-Bauer, Rafael Campo, Luis Bujanda, Ángel Ferrández, Virginia Piñol, Daniel Rodríguez-Alcalde, Martín Menéndez-Rodríguez, Natalia García-Morales, Cristina Pérez-Mosquera, and Joaquín Cubiella. 2020. "Predictive Value of Carcinoembryonic Antigen in Symptomatic Patients without Colorectal Cancer: A Post-Hoc Analysis within the COLONPREDICT Cohort" Diagnostics 10, no. 12: 1036. https://doi.org/10.3390/diagnostics10121036

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

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