Table 1.
Published studies evaluating the utility of serum CA19-9 as a screening marker for Pancreatic Cancer (1980–2010)
| Author, year | N= | CA 19-9 (> 37 U/ml) (N=) (%) | Pancreatic cancer (N=) | False positives (N=) | Sensitivity (%) | Specificity (%) | PPV (%) |
|---|---|---|---|---|---|---|---|
| Satake et al. 1994 [17] | 12,840a | 18 (0.2%) | 4 | 14 | NA | NA | NA |
| 8,706b | 198 (4.3%) | 85 | 113 | ||||
| Kim et al. 2004 [16] | 70,940 | 1,063 (1.5%) | 4 | 1,053 | 100 | 98.5 | 0.9 |
| Chang et al. 2006 [18] | 5,343 | 385 (7.2%) | 2 | 325 | 100 | 92.8 | 0.5 |
Published studies evaluating the role of serum CA 19-9 level suggest that it has no utility as a screening marker in asymptomatic individuals given its very low positive predictive value (0.5–0.9%). CA 19-9 serum level testing in symptomatic individuals (e.g., epigastric pain, weight loss and jaundice) is also suboptimal and identified pancreatic cancer in only 1.8% of such patients after an extensive work-up
U/ml unit/milliliter, PPV positive predictive value, NA not available
aAsymptomatic individuals
bSymptomatic individuals