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February 2, 1994

CEA for Monitoring Colon Cancer-Reply

Author Affiliations

Mayo Clinic Rochester, Minn

JAMA. 1994;271(5):346-347. doi:10.1001/jama.1994.03510290027025

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In Reply.  —Dr Chu and associates criticize our study because we did not regiment and standardize the conduct and interpretation of CEA monitoring. It was not our intention to do so. We wished only to document the results of monitoring as employed by a large and diverse group of physicians reasonably representative of those in cancer practice today. In this setting the CEA test performed poorly. If after nearly 30 years of CEA use American physicians haven't learned to do it right, it is doubtful that they ever will. Furthermore, if there is some nuance in the use of the CEA test that could accomplish the sow's-ear-to-silk-purse phenomenon, the burden of proof must be borne by those who make this claim.Drs Corman and Prager wishfully hope for some additional tests that will allow more rational decisions to be made regarding CEA-directed surgical intervention. They point to laparoscopy or immunoscintigraphy,

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