How reliable is an elevated CA 19-9 as a cancer marker?

I am sure you have done some research by now and know that CA19-9 is possibly elevated in conditions related to the stomach, liver, intestines (small and large) and commonly, the pancreas and biliary system (gallbladder and it's related structures).

The common scenario nowadays is that most health screening packages would include cancer markers and abnormal results in these markers naturally lead to alarm and worry.

I would however like to reassure you that based on one blood test result alone, we do not know whether you have cancer or not until we have done the necessary tests. This is because an elevated reading can be from non-cancer causes too e.g. pancreatitis.

What you need, and I would highly advise you to consider, is to undergo a detailed consultation and the necessary investigations to exclude cancers in the organs mentioned above, as well as identify any other non-cancerous conditions that can be serious in their own right.

This would reassure you of the significance of the raised CA19-9 results, and if so needed, undergo the necessary treatment of the reason for the abnormal result as soon as possible.

CA19-9 is a tumour marker for digestive tract related cancers; specifically for cancers of the pancreas and biliary system. Having said that, an elevated tumour marker does not necessary mean the presence of cancer, especially if it is just marginally raised.

Since your CA19-9 level is almost double, it will be prudent for you to get a proper assessment soon. If the repeat CA19-9 level shows a down trending pattern or normalises spontaneously, then there is a good chance we are dealing with a benign condition.

Please bring along all your recent test reports or scans during the assessment. If you have results from any previous health screening, do show your doctor too. This will help to avoid repeating tests unnecessarily.

- Dr Quan