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October 13, 1978

Role of CEA—A Challenge of a Verdict

Author Affiliations

The University of Texas System Cancer Center Houston

JAMA. 1978;240(16):1714. doi:10.1001/jama.1978.03290160032008

To the Editor.—  The recent article by Moertel et al (239:1065, 1978) leaves the reader with a pessimistic impression that "the CEA [carcinoembryonic antigen] assay is not a sensitive test for early detection of recurrence of colorectal cancer." Furthermore, the authors are also concerned about the "needless anxiety produced by premature knowledge of the presence of a fatal disease" in those (unfortunate?) cases where rising CEA levels may be helpful in early detection of recurrence because of "our limited therapeutic accomplishments under these circumstances."It is clear from the patient population studied by Moertel et al that only those with pelvic (local and regional) recurrence were selected for the study. In all fairness, these patients represent no more than 50% of the total population of colorectal cancer patients at risk after potentially curative surgery of the primary lesion. In this regard, the authors seem to ignore the relevant observations made