Drs Mavligit and McMurtrey have accurately represented our conclusion that the CEA test is insensitive for early detection of recurrence of colorectal carcinoma, as it is for early detection of primary carcinoma. They do not, however, present any convincing evidence to challenge this verdict. They are correct in their conclusion that we ignored the two publications they quote. In one of these, only two cases of pelvic recurrence were cited, and in the other, only five. We do not think that relevant observations regarding incidence can be made from population bases that can be counted on the fingers of one hand. We are pleased they agree that an adequate history and physical examination should supercede the CEA test in detecting pelvic recurrence of colorectal carcinoma. In our opinion the same conclusion should pertain in detecting recurrence elsewhere.
It is most disturbing that Drs Mavligit and McMurtrey have implied
Moertel CG. Role of CEA—A Challenge of a Verdict-Reply. JAMA. 1978;240(16):1714–1715. doi:10.1001/jama.1978.03290160032009
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