Question to general practitioner Maarten: Question about results of blood test with tumor marker CEA

Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.

Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information such as:

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Dear Martin,

Just before the major outbreak of the coronavirus, I had my blood tested in a local "prick office" that only takes blood and then sends it to a laboratory in Bangkok, after which you can collect the results after 2 days.

The man in question didn't speak English which is of any use to me, so I would like to know from you if the result number of 6.75 H CEA is something to be concerned about right away? Or that I can wait to go to a hospital until the coronavirus specter has died down and it's a little safer to go there? Google told me it's a tumor marker.

I am 79 years old do not smoke, drink half a bottle of wine a week, during meals. I am 76 kg, 175 cm tall and my blood pressure is unfortunately too high 178/85 (started with Enaril 20mg) and my BMI is 25,5.

But I am very curious about your thoughts on the urgency of the above value of my CEA value?

Thank you very much for your response.

Regards,

J.

*******

Dear J,

CEA is a coarse tumor marker, which should not be used for screening. It is a marker of tumor size.

Most laboratories assume a normal value of 5. For the elderly you can add ± 3 to this. The values ​​are also often elevated in, for example, diabetes, arthritis, high blood pressure. Above 20 the alarm bells start ringing.

In principle, you don't have to worry. The problem with all this testing is that one always finds something, especially with the elderly. People who get tested too often die earlier. This is probably because superfluous interventions and treatments are often performed. All this testing also causes fear, an emotion from which the medical sector earns a lot. Most screening tests have not been shown to improve quality and length of life. They do increase morbidity. CEA is such a redundant test.

In countries where doctors are allowed to strike, mortality is usually lower during the strike. However, if the strike lasts longer than 4 weeks, that will change. That makes you think

Yours faithfully,

Dr. Maarten