Lead-Time Trajectory Of CA19-9 As An Anchor Marker For Pancreatic Cancer Early Detection

Given that CA19-9 is an established circulating biomarker for pancreatic cancer, researchers sought to analyze its significance for early detection of pancreatic cancer or for monitoring at-risk individuals. Taken from the PLCO Cancer Screening Trial, CA19-9 levels were evaluated in blinded sera from 175 individuals collected up to 5 years before diagnosis of pancreatic cancer and from 875 matched controls. CA19-9 was assayed for comparison of performance in blinded independent sample sets obtained at diagnosis from 129 patients with resectable pancreatic cancer and 275 controls (100 healthy individuals; 50 with chronic pancreatitis; and 125 with non-cancerous pancreatic cysts). Comparison of resectable pancreatic cancer cases to patients with chronic pancreatitis resulted in 46% sensitivity at 99% specificity and for individuals with non-cancerous cysts 30% sensitivity at 99% specificity. Findings suggested that CA19-9 may serve as an anchor marker for early detection of pancreatic cancer. Levels of CA19-9 increased exponentially beginning at 2 years before diagnosis with sensitivities reaching 60% at 99% specificity within 0-6 months before diagnosis for all cases and 50% at 99% specificity for cases diagnosed with early-stage disease.

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