Evaluating The Efficacy of Carcinoembryonic Antigen in Standard Rectal Cancer Patient Surveillance: Does it Provide Benefits?

Abstract Introduction: Carcinoembryonic Antigen (CEA) has been linked to colorectal cancer cell adhesion and innate immunity. According to the National Institute for Health and Care Excellence (NICE), curative surgery is recommended for non-metastatic colorectal cancer, followed by a 3-year follow-up with CEA tests every 6 months and two chest, abdomen, and pelvis CT scans to detect recurrence. This study aimed to explore CEA's role in predicting both local and distant recurrence in comparison with computed tomography (CT) as the gold standard for rectal cancer. Methods: A retrospective analysis was conducted on all patients who were treated at the West Suffolk Hospital NHS Trust from 2014 to 2018. Electronic medical records of all eligible patients were reviewed to collect data on patient demographics, clinical characteristics, tumor characteristics, surgical details, adjuvant therapy, and follow-up data. Results: Of the 146 patients who underwent curative resection, 100 were male and 46 were female. During the 3-year follow-up period, 27.7% (40/146) of patients developed relapses. CEA was elevated in five patients, which was correlated with CT scans of the chest, abdomen, and pelvis. However, 31 patients were found to have metastasis in the follow-up CT scan, despite normal CEA levels. Conclusion: This study at the West Suffolk Hospital NHS Trust (2014-2018) emphasizes CEA's role in predicting rectal cancer recurrence after curative resection. While CEA is correlated with CT scans for some patients, it is not infallible, especially for distant metastases. Combining CEA and regular CT scans enhances surveillance and effectively detects local and distant recurrence. Further research is needed to establish surveillance for rectal cancer.