What carcinoembryonic antigen (CEA) level should trigger further investigation during colorectal cancer follow-up?

ISRCTN ISRCTN93652154
DOI https://doi.org/10.1186/ISRCTN93652154
ClinicalTrials.gov number NCT00560365
Secondary identifying numbers HTA 99/10/99 and HTA 11/136/81
Submission date
27/03/2013
Registration date
29/04/2013
Last edited
16/06/2017
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Not provided at time of registration

Contact information

Prof David Mant
Scientific

Oxford University Department of Primary Care Health Sciences
Oxford
OX2 6GG
United Kingdom

Phone +44 1865 289300
Email david.mant@phc.ox.ac.uk

Study information

Study designObservational diagnostic analysis of data collected for an ongoing randomised controlled trial
Primary study designObservational
Secondary study designOther
Study setting(s)Not specified
Study typeDiagnostic
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleWhat carcinoembryonic antigen (CEA) level should trigger further investigation during colorectal cancer follow-up? - an observational diagnostic data analysis
Study acronymFACS add-on study 2
Study hypothesisIt is feasible to increase the sensitivity of blood CEA as an indicator of recurrent colorectal cancer while retaining an acceptable level of specificity by specifying a positive result in terms of the change in blood CEA level over time rather than the absolute level of a single measurement.

Pilot study on http://www.isrctn.com/ISRCTN61091474
Main trial on http://www.isrctn.com/ISRCTN41458548
Ethics approval(s)NHS South-West Reserach Ethics Committee, 04/02/2002, ref: MREC/01/6/91
ConditionColorectal cancer follow-up
Intervention3-6 monthly blood CEA testing (already completed)
Intervention typeOther
Primary outcome measureThe main outcomes (cancer recurrence, treatment of recurrence with curative intent, and death) are monitored continuously. Blood CEA levels are measured 3 monthly for 2 years and 6 monthly for the next 3 years.
Secondary outcome measuresThis add-on analysis examining the diagnostic value of different methods of interpreting blood CEA to detect recurrence will include all outcomes at two time points - 3 years (interim analysis) and 5 years (final analysis) after trial entry.
Overall study start date01/04/2013
Overall study end date30/09/2013

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participantsThe 600 participants have already beeen recruited and 6000 blood test results are available for analysis analysis
Participant inclusion criteria1. Diagnosis of primary colorectal cancer. Stage I-III disease
2. Have undergone curative resection (i.e., no residual disease [R0]). Microscopically clear margins
3. Complete normal colonic imaging pre-operatively (or post-operatively if unable to view complete colon pre-operatively) by colonoscopy, barium enema, CT pneumocolon, or virtual colonoscopy
4. Post-operative blood CEA ≤ 10 ng/mL (if the normal range is ≤ 5 ng/mL) OR < 2 times upper limit of normal (if normal range is > 5 ng/mL). For patients undergoing adjuvant therapy, CEA should be measured after completion of chemotherapy
5. Has completed primary curative treatment, as deemed by hospital clinician. Patients awaiting stoma closure allowed
6. No evidence of metastatic disease on pre- or post-operative liver CT scan (or ultrasound) and chest CT scan (or chest x-ray)
7. No diagnosis of familial adenomatous polyposis (FAP) or dominantly inherited colon cancer
8. No concurrent serious illness
9. History of other carcinoma allowed provided primary treatment has been completed, there is no evidence of recurrent disease, and there is no follow-up that conflicts with study follow-up
10. Pre-operative radiotherapy or chemoradiotherapy for rectal cancer allowed provided curative resection has been achieved
11. No concurrent participation in a primary treatment clinical trial with conflicting follow-up requirements
12. Participation in the FACS trial in one of the two arms being followed-up with regular scheduled blood CEA tests.
Participant exclusion criteria1. Did not meet inclusion criteria
2. Unable to give written informed consent
Recruitment start date01/04/2013
Recruitment end date30/09/2013

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Oxford University Department of Primary Care Health Sciences
Oxford
OX2 6GG
United Kingdom

Sponsor information

Oxford University (UK)
University/education

Radcliffe Observatory Quarter
Oxford
OX2 6GG
England
United Kingdom

Funders

Funder type

Government

Health Technology Assessment Programme
Government organisation / National government
Alternative name(s)
NIHR Health Technology Assessment Programme, HTA
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/04/2017 Yes No

Editorial Notes

16/06/2017: Publication reference added.