by Dr. C.H. Weaver M.D. updated 3/2019
According to a study in the Journal of Gastrointestinal Surgery, a simple widely available blood test could improve treatment for more than 1 in 6 stage 2 colon cancer patients. The researchers also discovered that many patients who could benefit from the test likely aren’t receiving it.1
Colorectal cancer remains the second leading cause of cancer-related deaths in the U.S. although death rates from colorectal cancer have declined in the past 10 years which is thought to be due to increased screening and newer drugs to treat the disease.
The delivery of cancer treatment following local treatment with surgery is referred to as “adjuvant” therapy and may include chemotherapy, radiation therapy, and/or targeted therapy. Adjuvant chemotherapy improves outcomes among patients with Stage III colon cancer, but the benefits among patients with Stage II colon cancer are less clear. Adjuvant chemotherapy may improve disease-free and overall survival of some but not all patients with Stage II colon cancer. Routine use of adjuvant chemotherapy is not recommended for patients with Stage II colon cancer, but it may be considered for some patients, particularly those whose cancers have high-risk features.2
Using data from the National Cancer Database for 40,844 patients, Mayo Clinic physicians and scientists teamed up to look at benefits of a blood test that measures the protein called carcinoembryonic antigen (CEA) which can be found in higher levels in people with certain cancers, especially colon cancer.
The researchers found that knowing these blood test results prior to treatment could have changed the classification for 17 percent of stage 2 colon cancer patients from average risk to high risk. High risk stage 2 colon cancer patients are more likely to benefit from chemotherapy treatment following surgery.
The researchers also discovered that, for stage 2 patients who had surgery but not chemotherapy, the five-year survival rate was 66 percent for those with elevated protein levels and 76 percent for those without elevated levels. And for patients with elevated protein levels, those who had chemotherapy and surgery fared better than those who only had surgery.
- Spindler BA, Bergquist JR, Thiels CA, et al. Incorporation of CEA Improves Risk Stratification in Stage II Colon Cancer. J Gastrointest Surg. 2017 May;21(5):770-777.
- Figueredo A, Charette M, Maroun J, et al. Adjuvant therapy for stage II colon cancer: A systematic review from the Cancer Care Ontario Program in Evidence-based Care’s Gastrointestinal Cancer Disease Site Group. Journal of Clinical Oncology. 2004;22: 3395-3407.
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