Characteristics of carcinoembryonic antigen-producing colorectal cancers: A population based study

Sarah Groover, Rashmi Kaul, Sarah E. Johnston, Yan D. Zhao, Asha Karippot, Pragatheeshwar Thirunavukarasu

Research output: Contribution to journalArticle

Abstract

Objectives: Serum carcinoembryonic antigen is a tumor marker often found to be elevated in colorectal cancer patients. Elevated carcinoembryonic antigen has been strongly associated with poor prognosis. However, little is known about the patient and tumor characteristics between carcinoembryonic antigen-secreting and non-secreting tumors. Methods: We performed a retrospective analysis of all patients (N=164,187) in the Surveillance, Epidemiology and End Results database diagnosed with colorectal adenocarcinoma from 2010 to 2014. All patients were designated as having either positive/elevated (C1) or negative/normal (C0) pretreatment serum carcinoembryonic antigen level. Results: Of the 164,187 patients, 68,833 (57.0%) had available carcinoembryonic antigen information, and 33,412 (48.5%) had positive/elevated (C1) antigen levels. Median age was 65 years, and 36,464 (53.0%) were male. Patients with C1 cancers were more likely to be female (Odds ratio 1.06), black (Odds ratio 1.62), separated or never married (Odds ratios 1.50 and 1.49, respectively), higher grade (Odds ratios 1.35, 1.64, and 1.72 of moderately, poorly, and undifferentiated cancers, respectively), and of signet ring cell histology (Odds ratio 1.47) compared to males, whites, married participants, well differentiated grade, and adenocarcinoma histology respectively (P<0.001). Multivariate analysis showed that non-Caucasian race, female gender, unmarried status, distal to sigmoid colon location, increasing tumor invasion beyond muscular layer, increasing nodal involvement, and presence of metastases were independent factors associated with the C1 diagnosis. Conclusions: About half of all colorectal adenocarcinomas are associated with elevated pre-treatment serum carcinoembryonic antigen levels. Our study is the first nationwide population-based study quantifying the prevalence of serum carcinoembryonic antigen elevation in the colorectal cancer population, and identifying patient and tumor characteristics associated with elevated carcinoembryonic antigen.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalArchive of Oncology
Volume25
Issue number1
DOIs
StatePublished - 1 Jan 2019

Fingerprint

Carcinoembryonic Antigen
Colorectal Neoplasms
Odds Ratio
Population
Neoplasms
Adenocarcinoma
Serum
Histology
Sigmoid Colon
Tumor Biomarkers
Epidemiology
Multivariate Analysis
Cross-Sectional Studies
Databases
Neoplasm Metastasis
Antigens

Keywords

  • Adenocarcinoma
  • Biomarkers
  • Carcinoembryonic antigen
  • Colorectal cancer
  • Epidemiology
  • Multivariate analysis
  • Risk factors
  • Seer program
  • Serum
  • United states

Cite this

Groover, Sarah ; Kaul, Rashmi ; Johnston, Sarah E. ; Zhao, Yan D. ; Karippot, Asha ; Thirunavukarasu, Pragatheeshwar. / Characteristics of carcinoembryonic antigen-producing colorectal cancers : A population based study. In: Archive of Oncology. 2019 ; Vol. 25, No. 1. pp. 1-8.
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abstract = "Objectives: Serum carcinoembryonic antigen is a tumor marker often found to be elevated in colorectal cancer patients. Elevated carcinoembryonic antigen has been strongly associated with poor prognosis. However, little is known about the patient and tumor characteristics between carcinoembryonic antigen-secreting and non-secreting tumors. Methods: We performed a retrospective analysis of all patients (N=164,187) in the Surveillance, Epidemiology and End Results database diagnosed with colorectal adenocarcinoma from 2010 to 2014. All patients were designated as having either positive/elevated (C1) or negative/normal (C0) pretreatment serum carcinoembryonic antigen level. Results: Of the 164,187 patients, 68,833 (57.0{\%}) had available carcinoembryonic antigen information, and 33,412 (48.5{\%}) had positive/elevated (C1) antigen levels. Median age was 65 years, and 36,464 (53.0{\%}) were male. Patients with C1 cancers were more likely to be female (Odds ratio 1.06), black (Odds ratio 1.62), separated or never married (Odds ratios 1.50 and 1.49, respectively), higher grade (Odds ratios 1.35, 1.64, and 1.72 of moderately, poorly, and undifferentiated cancers, respectively), and of signet ring cell histology (Odds ratio 1.47) compared to males, whites, married participants, well differentiated grade, and adenocarcinoma histology respectively (P<0.001). Multivariate analysis showed that non-Caucasian race, female gender, unmarried status, distal to sigmoid colon location, increasing tumor invasion beyond muscular layer, increasing nodal involvement, and presence of metastases were independent factors associated with the C1 diagnosis. Conclusions: About half of all colorectal adenocarcinomas are associated with elevated pre-treatment serum carcinoembryonic antigen levels. Our study is the first nationwide population-based study quantifying the prevalence of serum carcinoembryonic antigen elevation in the colorectal cancer population, and identifying patient and tumor characteristics associated with elevated carcinoembryonic antigen.",
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Characteristics of carcinoembryonic antigen-producing colorectal cancers : A population based study. / Groover, Sarah; Kaul, Rashmi; Johnston, Sarah E.; Zhao, Yan D.; Karippot, Asha; Thirunavukarasu, Pragatheeshwar.

In: Archive of Oncology, Vol. 25, No. 1, 01.01.2019, p. 1-8.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Characteristics of carcinoembryonic antigen-producing colorectal cancers

T2 - A population based study

AU - Groover, Sarah

AU - Kaul, Rashmi

AU - Johnston, Sarah E.

AU - Zhao, Yan D.

AU - Karippot, Asha

AU - Thirunavukarasu, Pragatheeshwar

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: Serum carcinoembryonic antigen is a tumor marker often found to be elevated in colorectal cancer patients. Elevated carcinoembryonic antigen has been strongly associated with poor prognosis. However, little is known about the patient and tumor characteristics between carcinoembryonic antigen-secreting and non-secreting tumors. Methods: We performed a retrospective analysis of all patients (N=164,187) in the Surveillance, Epidemiology and End Results database diagnosed with colorectal adenocarcinoma from 2010 to 2014. All patients were designated as having either positive/elevated (C1) or negative/normal (C0) pretreatment serum carcinoembryonic antigen level. Results: Of the 164,187 patients, 68,833 (57.0%) had available carcinoembryonic antigen information, and 33,412 (48.5%) had positive/elevated (C1) antigen levels. Median age was 65 years, and 36,464 (53.0%) were male. Patients with C1 cancers were more likely to be female (Odds ratio 1.06), black (Odds ratio 1.62), separated or never married (Odds ratios 1.50 and 1.49, respectively), higher grade (Odds ratios 1.35, 1.64, and 1.72 of moderately, poorly, and undifferentiated cancers, respectively), and of signet ring cell histology (Odds ratio 1.47) compared to males, whites, married participants, well differentiated grade, and adenocarcinoma histology respectively (P<0.001). Multivariate analysis showed that non-Caucasian race, female gender, unmarried status, distal to sigmoid colon location, increasing tumor invasion beyond muscular layer, increasing nodal involvement, and presence of metastases were independent factors associated with the C1 diagnosis. Conclusions: About half of all colorectal adenocarcinomas are associated with elevated pre-treatment serum carcinoembryonic antigen levels. Our study is the first nationwide population-based study quantifying the prevalence of serum carcinoembryonic antigen elevation in the colorectal cancer population, and identifying patient and tumor characteristics associated with elevated carcinoembryonic antigen.

AB - Objectives: Serum carcinoembryonic antigen is a tumor marker often found to be elevated in colorectal cancer patients. Elevated carcinoembryonic antigen has been strongly associated with poor prognosis. However, little is known about the patient and tumor characteristics between carcinoembryonic antigen-secreting and non-secreting tumors. Methods: We performed a retrospective analysis of all patients (N=164,187) in the Surveillance, Epidemiology and End Results database diagnosed with colorectal adenocarcinoma from 2010 to 2014. All patients were designated as having either positive/elevated (C1) or negative/normal (C0) pretreatment serum carcinoembryonic antigen level. Results: Of the 164,187 patients, 68,833 (57.0%) had available carcinoembryonic antigen information, and 33,412 (48.5%) had positive/elevated (C1) antigen levels. Median age was 65 years, and 36,464 (53.0%) were male. Patients with C1 cancers were more likely to be female (Odds ratio 1.06), black (Odds ratio 1.62), separated or never married (Odds ratios 1.50 and 1.49, respectively), higher grade (Odds ratios 1.35, 1.64, and 1.72 of moderately, poorly, and undifferentiated cancers, respectively), and of signet ring cell histology (Odds ratio 1.47) compared to males, whites, married participants, well differentiated grade, and adenocarcinoma histology respectively (P<0.001). Multivariate analysis showed that non-Caucasian race, female gender, unmarried status, distal to sigmoid colon location, increasing tumor invasion beyond muscular layer, increasing nodal involvement, and presence of metastases were independent factors associated with the C1 diagnosis. Conclusions: About half of all colorectal adenocarcinomas are associated with elevated pre-treatment serum carcinoembryonic antigen levels. Our study is the first nationwide population-based study quantifying the prevalence of serum carcinoembryonic antigen elevation in the colorectal cancer population, and identifying patient and tumor characteristics associated with elevated carcinoembryonic antigen.

KW - Adenocarcinoma

KW - Biomarkers

KW - Carcinoembryonic antigen

KW - Colorectal cancer

KW - Epidemiology

KW - Multivariate analysis

KW - Risk factors

KW - Seer program

KW - Serum

KW - United states

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JO - Archive of Oncology

JF - Archive of Oncology

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