CARCINOEMBRYONIC ANTIGEN MONITORING IN THE FOLLOW-UP OF COLORECTAL-CANCER PATIENTS - A DECISION-ANALYSIS

The routine use of serial carcinoembryonic antigen (CEA) determination s in colorectal cancer patients operated on for cure is still controve rsial. A decision analysis was performed, comparing follow-up with and without CEA. The quality-adjusted life expectancy of an average color ectal cancer patient receiving follow-up with CEA (10.85 years) was 1 month shorter than without CEA (10.93 years). The life expectancy of y ounger patients with advanced colorectal cancer is improved by the use of CEA, while the use of CEA in older patients with low-risk primary tumors (Dukes A) will lead to increased mortality and shorter life exp ectancy. Operative mortality was identified as the most important fact or limiting the use of CEA. Future improvements of CEA testing and ope ration techniques, and the use of CEA in selected patient groups, may lead to better survival.