CEA to Detect Recurrence of Colon Cancer

To the Editor. —We have been following with interest the correspondence in response to the recently published article by Dr Moertel and associates1on carcinoembryonic antigen (CEA) monitoring in the postoperative follow-up of patients treated for colorectal cancer. Moertel et al conclude that not only is such monitoring poorly carried out, but that it has little value in the early detection of resectable recurrence. Furthermore, the financial resources could be more appropriately diverted to research. We too have been concerned with the controversy surrounding the role of CEA monitoring in such patients, but felt that without a clear and reliable demonstration of efficacy, the only solution was to organize a prospective, randomized, controlled, double-blinded trial. In 1982, we launched the CRC/NIH CEA Second-Look Trial, which was designed to give a definitive evaluation of CEA. Patients were recruited from the United Kingdom and Europe, and by February 1993, 1447 patients