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Carcinoembryonic antigen (CEA)

Test Background

CEA is a tumour-associated cell surface glycoprotein of 200 kDa normally expressed in embryonic and fetal gut tissues. It can be elevated in almost any advanced adenocarcinoma including breast, prostate, liver, gastric, lung, pancreatic or ovarian cancer, but has greatest usefulness in colorectal carcinoma. It is rarely elevated early in malignancies.

Benign conditions in which a raised CEA may be observed include: hepatitis, cirrhosis, alcoholic liver disease, inflammatory bowel disease (Crohn’s and ulcerative colitis), pancreatitis, bronchitis, emphysema and renal disease. It may also be elevated in heavy smokers.

Clinical Indications

Colorectal cancer

Diagnosis: due to low clinical sensitivity CEA is not recommended for screening. It may aid diagnosis in high risk groups as an adjunctive test.

Prognosis and staging: pre-operative CEA measurement provides prognostic information and can be used in combination with other factors in planning treatment. Raised levels should be evaluated for the presence of distant metastases.

Treatment monitoring: CEA should be measured at the start of treatment for metastatic disease and every 1-3 months during treatment. Increasing concentrations suggest progressive disease.

Surveillance: in asymptomatic patients CEA is the most frequent indicator of recurrence. Measurement of CEA is recommended every 3 months in patients with stage II/III disease for at least 3 years following diagnosis.

General: May be useful in other gastrointestinal malignancies as a general purpose marker for adenocarcinomas, especially for treatment monitoring and surveillance following treatment.

Reference Range

≤5 μg/L

Sample volume
0.5 mL
Turnaround time
4 days
Sample & Container Required
SST (gold top) preferred, serum (red top) accepted
Notes

Abbott Alinity

Please note: This test is now also available at Hillingdon, but UKAS accreditation for this site is pending.

Record last updated
September 5, 2025

Sample Container

5ml SST Vacutainers (Gold / Yellow top)

Sample Container

6ml Plain Vacutainers (Red top)

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Test Results

Yes, we have a Pathology User Guide

Yes. Please email your request to Imperial.nwlpcustomerservice@nhs.net

Results are communicated to clinical staff and are normally not communicated direct to patients either on telephone requests or in written report. If you need to contact us please click here to view the contact details page

Please contact the Customer Service Team Monday to Friday from 8:30am – 6:00pm on 0203 313 5353. Alternatively, see the Pathology User Guide for how to contact the relevant department. If advice is not urgent you can also email your query to Imperial.nwlpcustomerservice@nhs.net

Additional tests may be added by discussion with the relevant laboratory. The time limit for adding additional tests to a sample already received in the laboratory will depend on the type of sample and the department it was sent to.

Information on the repertoire of tests performed by pathology, including reference ranges, turnaround times and specimen requirements, can be found in the test directory.

NWLP operates UKAS accredited medical laboratories as per the references below. The current scope of accreditation for all NWLP’s laboratories can be found on the UKAS website.

See the following UKAS ref numbers:

  • Clinical Biochemistry Ref: 8673
  • Haematology and Blood Transfusion Ref: 8674
  • Infection & Immunity Sciences (Including Immunology, Virology, Microbiology and Histocompatibility and Immunogenetics ) Ref: 8659
  • Cellular Pathology (Including Histopathology, Cytology and Molecular Pathology) Ref: 9615

If you require copies of our certificate of accreditation and associated documentation please contact Imperial.nwlpcustomerservice@nhs.net.

UKAS requires the laboratories to be accredited for a particular repertoire/scope (ISO15189), any changes or additions to repertoire require assessment by UKAS (extension to scope).

The BD Hospital Tube GuideBD GP Tube Guide and BD Paediatric Tube Guide provide visual references to the correct tube types and collection instructions.

Home testing

INSTRUCTION SHEET FOR BLOOD SAMPLE COLLECTION 

We also have two instruction videos available (one with subtitles and one without) – please click on the links to view the videos on Google.

VIDEO ON BLOOD SAMPLE COLLECTION (without subtitles)

VIDEO ON BLOOD SAMPLE COLLECTION (with subtitles)

Our accreditations

Upholding excellence in diagnostic standards

Our laboratories are accredited by the UK Accreditation Service (UKAS) against the international standard ISO15189:2022. UKAS is the accreditation body for the UK that assesses medical laboratories.

Find out more about our accreditations on the UKAS website.

UKAS website
Man in the lab handling a sample