Should a colonoscopy be recommended for healthy individuals with increased carcinoembryonic antigen levels? A case-control study

Jin Ha Lee, Sung Pil Hong, Tae Joo Jeon, Gun Hi Kang, Won Choong Choi, Soung Min Jeon, Chang Mo Moon, Jae Jun Park, JaeHee Cheon, Tae Il Kim, Won Ho Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background and Aim: Despite the limitations of screening or early diagnosis of colorectal cancers (CRC), carcinoembryonic antigen (CEA) is frequently measured in practice and during health promotion programs. The aim of this study was to evaluate the role of colonoscopy in healthy individuals with elevated CEA levels. Methods: From January 2003 to November 2008, 117,731 healthy persons underwent an opportunistic screening program in two health promotion centers; 1,497 subjects (1.3%) showed an elevated CEA level (>5 ng/ml). Among them, 174 patients were recruited to undergo a colonoscopy to determine if colorectal malignancies were present. A total of 372 age- and sex-matched persons were selected as controls from among the healthy subjects who had a normal level of CEA and had received surveillance colonoscopy. The primary outcome was the incidences of CRC in elevated CEA and normal CEA groups. The secondary outcome was the predictive factors of CRC in the elevated CEA group. Results: The incidence of CRC was higher in the group with higher CEA-levels than in the group with normal CEA levels (4.6 vs. 1.3%; P = 0.031). In the CEA-elevated group, patients with CRCs were diagnosed at more advanced stages than were those in the CEA-normal group. The incidence of colorectal polyps was not different between the two groups. In the CEA-elevated group, anemia was an independent predictive factor of CRCs by multivariate analysis (P = 0.002). Conclusion: Anemia itself is not a predictive factor of CRC in the entire population, but is an independent predictive factor of CRC in healthy individuals with an elevated level of CEA. Therefore, colonoscopy should be recommended for healthy subjects with an elevated level of CEA accompanied with anemia in the absence of other adenocarcinomas to evaluate the presence of colorectal malignancy.

Original languageEnglish
Pages (from-to)2396-2403
Number of pages8
JournalDigestive Diseases and Sciences
Volume56
Issue number8
DOIs
Publication statusPublished - 2011 Aug 1

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Carcinoembryonic Antigen
Colonoscopy
Case-Control Studies
Colorectal Neoplasms
Anemia
Health Promotion
Incidence
Healthy Volunteers
Polyps
Early Detection of Cancer
Neoplasms
Adenocarcinoma

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

Cite this

Lee, Jin Ha ; Hong, Sung Pil ; Jeon, Tae Joo ; Kang, Gun Hi ; Choi, Won Choong ; Jeon, Soung Min ; Moon, Chang Mo ; Park, Jae Jun ; Cheon, JaeHee ; Kim, Tae Il ; Kim, Won Ho. / Should a colonoscopy be recommended for healthy individuals with increased carcinoembryonic antigen levels? A case-control study. In: Digestive Diseases and Sciences. 2011 ; Vol. 56, No. 8. pp. 2396-2403.
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title = "Should a colonoscopy be recommended for healthy individuals with increased carcinoembryonic antigen levels? A case-control study",
abstract = "Background and Aim: Despite the limitations of screening or early diagnosis of colorectal cancers (CRC), carcinoembryonic antigen (CEA) is frequently measured in practice and during health promotion programs. The aim of this study was to evaluate the role of colonoscopy in healthy individuals with elevated CEA levels. Methods: From January 2003 to November 2008, 117,731 healthy persons underwent an opportunistic screening program in two health promotion centers; 1,497 subjects (1.3{\%}) showed an elevated CEA level (>5 ng/ml). Among them, 174 patients were recruited to undergo a colonoscopy to determine if colorectal malignancies were present. A total of 372 age- and sex-matched persons were selected as controls from among the healthy subjects who had a normal level of CEA and had received surveillance colonoscopy. The primary outcome was the incidences of CRC in elevated CEA and normal CEA groups. The secondary outcome was the predictive factors of CRC in the elevated CEA group. Results: The incidence of CRC was higher in the group with higher CEA-levels than in the group with normal CEA levels (4.6 vs. 1.3{\%}; P = 0.031). In the CEA-elevated group, patients with CRCs were diagnosed at more advanced stages than were those in the CEA-normal group. The incidence of colorectal polyps was not different between the two groups. In the CEA-elevated group, anemia was an independent predictive factor of CRCs by multivariate analysis (P = 0.002). Conclusion: Anemia itself is not a predictive factor of CRC in the entire population, but is an independent predictive factor of CRC in healthy individuals with an elevated level of CEA. Therefore, colonoscopy should be recommended for healthy subjects with an elevated level of CEA accompanied with anemia in the absence of other adenocarcinomas to evaluate the presence of colorectal malignancy.",
author = "Lee, {Jin Ha} and Hong, {Sung Pil} and Jeon, {Tae Joo} and Kang, {Gun Hi} and Choi, {Won Choong} and Jeon, {Soung Min} and Moon, {Chang Mo} and Park, {Jae Jun} and JaeHee Cheon and Kim, {Tae Il} and Kim, {Won Ho}",
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Lee, JH, Hong, SP, Jeon, TJ, Kang, GH, Choi, WC, Jeon, SM, Moon, CM, Park, JJ, Cheon, J, Kim, TI & Kim, WH 2011, 'Should a colonoscopy be recommended for healthy individuals with increased carcinoembryonic antigen levels? A case-control study', Digestive Diseases and Sciences, vol. 56, no. 8, pp. 2396-2403. https://doi.org/10.1007/s10620-011-1606-1

Should a colonoscopy be recommended for healthy individuals with increased carcinoembryonic antigen levels? A case-control study. / Lee, Jin Ha; Hong, Sung Pil; Jeon, Tae Joo; Kang, Gun Hi; Choi, Won Choong; Jeon, Soung Min; Moon, Chang Mo; Park, Jae Jun; Cheon, JaeHee; Kim, Tae Il; Kim, Won Ho.

In: Digestive Diseases and Sciences, Vol. 56, No. 8, 01.08.2011, p. 2396-2403.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Should a colonoscopy be recommended for healthy individuals with increased carcinoembryonic antigen levels? A case-control study

AU - Lee, Jin Ha

AU - Hong, Sung Pil

AU - Jeon, Tae Joo

AU - Kang, Gun Hi

AU - Choi, Won Choong

AU - Jeon, Soung Min

AU - Moon, Chang Mo

AU - Park, Jae Jun

AU - Cheon, JaeHee

AU - Kim, Tae Il

AU - Kim, Won Ho

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Background and Aim: Despite the limitations of screening or early diagnosis of colorectal cancers (CRC), carcinoembryonic antigen (CEA) is frequently measured in practice and during health promotion programs. The aim of this study was to evaluate the role of colonoscopy in healthy individuals with elevated CEA levels. Methods: From January 2003 to November 2008, 117,731 healthy persons underwent an opportunistic screening program in two health promotion centers; 1,497 subjects (1.3%) showed an elevated CEA level (>5 ng/ml). Among them, 174 patients were recruited to undergo a colonoscopy to determine if colorectal malignancies were present. A total of 372 age- and sex-matched persons were selected as controls from among the healthy subjects who had a normal level of CEA and had received surveillance colonoscopy. The primary outcome was the incidences of CRC in elevated CEA and normal CEA groups. The secondary outcome was the predictive factors of CRC in the elevated CEA group. Results: The incidence of CRC was higher in the group with higher CEA-levels than in the group with normal CEA levels (4.6 vs. 1.3%; P = 0.031). In the CEA-elevated group, patients with CRCs were diagnosed at more advanced stages than were those in the CEA-normal group. The incidence of colorectal polyps was not different between the two groups. In the CEA-elevated group, anemia was an independent predictive factor of CRCs by multivariate analysis (P = 0.002). Conclusion: Anemia itself is not a predictive factor of CRC in the entire population, but is an independent predictive factor of CRC in healthy individuals with an elevated level of CEA. Therefore, colonoscopy should be recommended for healthy subjects with an elevated level of CEA accompanied with anemia in the absence of other adenocarcinomas to evaluate the presence of colorectal malignancy.

AB - Background and Aim: Despite the limitations of screening or early diagnosis of colorectal cancers (CRC), carcinoembryonic antigen (CEA) is frequently measured in practice and during health promotion programs. The aim of this study was to evaluate the role of colonoscopy in healthy individuals with elevated CEA levels. Methods: From January 2003 to November 2008, 117,731 healthy persons underwent an opportunistic screening program in two health promotion centers; 1,497 subjects (1.3%) showed an elevated CEA level (>5 ng/ml). Among them, 174 patients were recruited to undergo a colonoscopy to determine if colorectal malignancies were present. A total of 372 age- and sex-matched persons were selected as controls from among the healthy subjects who had a normal level of CEA and had received surveillance colonoscopy. The primary outcome was the incidences of CRC in elevated CEA and normal CEA groups. The secondary outcome was the predictive factors of CRC in the elevated CEA group. Results: The incidence of CRC was higher in the group with higher CEA-levels than in the group with normal CEA levels (4.6 vs. 1.3%; P = 0.031). In the CEA-elevated group, patients with CRCs were diagnosed at more advanced stages than were those in the CEA-normal group. The incidence of colorectal polyps was not different between the two groups. In the CEA-elevated group, anemia was an independent predictive factor of CRCs by multivariate analysis (P = 0.002). Conclusion: Anemia itself is not a predictive factor of CRC in the entire population, but is an independent predictive factor of CRC in healthy individuals with an elevated level of CEA. Therefore, colonoscopy should be recommended for healthy subjects with an elevated level of CEA accompanied with anemia in the absence of other adenocarcinomas to evaluate the presence of colorectal malignancy.

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U2 - 10.1007/s10620-011-1606-1

DO - 10.1007/s10620-011-1606-1

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EP - 2403

JO - American Journal of Digestive Diseases

JF - American Journal of Digestive Diseases

SN - 0002-9211

IS - 8

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