Cancer Screening - Male

Key Aspects of CEA Testing

• Purpose: Not for screening, but to monitor cancer progression, treatment response, and recurrence (especially in colorectal cancer).
• Common Causes of Elevated CEA: Colorectal cancer, breast cancer, lung cancer, medullary thyroid cancer, and pancreatic cancer.
• Non-cancerous (Benign) Causes: Smoking, inflammatory bowel disease (IBD), pancreatitis, liver disease (cirrhosis, hepatitis), and infections.
• Limitations: CEA is not highly specific for cancer. A low level does not always mean a cancer has not returned.

CA 19-9

Key Aspects of CA 19-9 (Cancer Antigen 19-9)

• Purpose: Primarily used to monitor how well pancreatic cancer treatment is working, check for recurrence, or manage bile duct cancers.
• Normal Range: Generally, a normal CA 19-9 level is less than 37 U/mL.
• Significance of High Levels: Elevated levels can indicate advanced pancreatic cancer, bile duct cancer (cholangiocarcinoma), colorectal cancer, or stomach cancer.
• Non-Cancerous Causes (Benign Conditions): Elevated levels do not always mean cancer. They can be caused by:
  • Pancreatitis (inflammation of the pancreas)
  • Gallstones or biliary infections (cholangitis)
  • Liver disease (cirrhosis)
  • Cystic fibrosis
• Limitations: It cannot be used as a standalone diagnostic or screening test because it is not specific enough to cancer.

Key Aspects of the Total PSA Test:

• Purpose: Primarily screens for prostate cancer and monitors for recurrence after treatment.
• Procedure: A standard blood sample is taken from the arm, usually at a doctor's office or lab.
• Preparation: Avoid ejaculation or vigorous physical activity (e.g., cycling) for 24–48 hours prior to the test to avoid false positives.
• Limitations: High PSA does not guarantee cancer, and low PSA does not totally rule it out. It is often paired with a Digital Rectal Exam (DRE).
• Factors Affecting Levels: Age, prostatitis, Benign Prostatic Hyperplasia (BPH), and recent urological procedures can raise PSA levels.

It is recommended that men discuss the benefits and risks of screening with their doctor, particularly starting at age 55, or earlier for higher-risk individuals.