CEA Tests: are they worth it?

[samtam]

As part of my annual check up, I have a CEA blood test. Since I started having them at BNH my CEA has gone from 5.30 in 2014 to 7.50 yesterday, and steadily rising by small increments within that time frame. In February I had a test and it was 6.50, and yesterday 7.50.

 

I am now going to have a CAT scan on Wednesday to check my pancreas and lungs. I am a non-smoker.

 

After my result in 2014 @ 5.30 I had a colonoscopy, approx THB20-30K, I can't remember. (Yesterday they suggested that the colonoscopy done in 2014 wasn't that "clean", so although at the time they suggested 10 years for the next one, they are now suggesting another one should be done now.) The next test CAT scan will cost THB42,000 and change. I have read that CEA should not be used for cancer screening, and yet this appears to be what BNH does, and at financial benefit to them, and cost to me.

 

Fear plays a part in my choice to proceed with these tests, but I wonder if I am being paranoid.

 

An impartial medical comment would be welcome.

 

Thanks.

[RotBenz8888]

The CEA should only be used to check for cancer recurrence, ex after surgical removal of colon cancer. Not for screening or diagnosis.

 

A slightly elevated test will force you into endless search for a tumor that might not be there, hence a lot of worry for nothing. Private hospitals provide these tests for obvious reasons.

 

Other causes than cancer can raise CEA. Are you a smoker? Have other gastrointestinal diseases like peptic ulcer, IBD, Divertikulitis, liver disease?

 

[samtam]

Thanks. Yes, it seems an endless quest that costs an indeterminate amount.

No, as I said, I'm a non-smoker, and I do not have symptoms for the other prognoses you list.

 

Are you a doctor? If so, would you suggest I just leave it be for now?

[Sheryl]

As other poster said CEA is not appropriate for screening purposes and no health authority recommends it.

If over 50 you should have colonoscopy every 10 years, more often if any atypical results or family history of colon cancer.

You need to get to the bottom of the conflicting info re results of your 2014 colonoscopy. Do you not have the report?

Why on earth are you having CAT scan to check pancreas and lung?? CAT scans also are not suitable for general screening and entail considerable radiation exposure.

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[samtam]

Thanks Sheryl. Based on your comments and that of RotBenz8888, I have cancelled the CT scan. I have left a message with my gastroenterologist, (who performed the colonoscopy) to find out why his colleague questioned the result of the colonoscopy in 2014. I do have a copy of the result, but not to hand, but I recall he said the next one should be in 10 years, (I'm 62).

 

Why a CT scan was recommended, I have no idea, but he can explain that one too.

 

I'm beginning to lose faith in BNH, as they are very expensive for every visit, however rare, with the "vitals check" at THB200 a pop before you even start. Do you recommend another hospital? (I have used Bumrungrad before for their optometry department before BNH's improved, and St Louis for their acupuncturist, both of which were good, but the former is teeming with medical tourists, and (on the surface) the latter seemed a bit sleepy and without up-to-date facilities. 

[samtam]

Actually the "vitals check" is THB350 a pop...

[Sheryl]

The hospital surcharge is not a fee for having you vital signs taken. It is an add on for use of the hospital facility in general and all private hospitals do this, amounts vary from 200 - 500 baht.

 

The choice of doctor is much more important than choice of hospital. Doctors in private hospitals are independent contractors with complete autonomy in how they practice and you can get completely different treatment at the same hospital depending on the doctor.

 

For GI, Dr. Varocha at Bangkok Hospital is good. Bring prior report and CD of the last endoscopy.

 

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[samtam]

Thanks Sheryl.