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February 2, 1994

CEA for Monitoring Colon Cancer

JAMA. 1994;271(5):345-346. doi:10.1001/jama.1994.03510290027022

To the Editor.  —In their recently published article, Moertel et al1 concluded that carcinoembryonic antigen (CEA) monitoring has questionable value in the postoperative management of colorectal cancer patients, and that routine determination of postoperative CEA levels is associated with significant expense, without benefit to the patient.While it is important to question the utility of costly testing, we do not feel that the conclusions reached in the article are supported by the data presented. There was no standardized regimen of CEA testing or follow-up of results; the number of CEA levels measured per patient ranged from one to 39; it is unclear whether levels were measured prior to or only after clinical suspicion of metastatic disease; there was no standardized method of interpreting the CEA results or acting on those results, and no standardized protocol was established for evaluating elevated CEA results. In addition, it is probably inappropriate to