ArticleClinical cancer research : an official journal of the American Association for Cancer Research2015
Serum CA19-9 is significantly upregulated up to 2 years before diagnosis with pancreatic cancer: implications for early disease detection.
Article in Clinical cancer research : an official journal of the American Association for Cancer Research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 113 papers, 6 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
113 citing papers in PubMed, 6 syntheses or guidelines pooled it, 195 citations in OpenAlex.
- Diagnostic valuation of MMP family members as biomarkers for pancreatic cancer: a systematic review and meta-analysis.Biomarkers in medicine · 2025Pooled it
- From radiomics to transformers in pancreatic cancer detection and prognosis.Frontiers in medicine · 2025Pooled it
- Pooled it
- Diagnostic Accuracy of Blood-based Biomarkers for Pancreatic Cancer: A Systematic Review and Meta-analysis.Cancer research communications · 2022Pooled it
- Identifying Novel Biomarkers Ready for Evaluation in Low-Prevalence Populations for the Early Detection of Upper Gastrointestinal Cancers: A Systematic Review.Advances in therapy · 2021Pooled it
- Pooled it
- Lead-Time Trajectory of CA19-9 as an Anchor Marker for Pancreatic Cancer Early Detection.Gastroenterology · 2021Trial
- THBS2/CA19-9 Detecting Pancreatic Ductal Adenocarcinoma at Diagnosis Underperforms in Prediagnostic Detection: Implications for Biomarker Advancement.Cancer prevention research (Philadelphia, Pa.) · 2021Trial
- Time-frequency analysis of serum with proton nuclear magnetic resonance for diagnosis of pancreatic cancer.Scientific reports · 2020Trial
- A combined biomarker panel shows improved sensitivity for the early detection of ovarian cancer allowing the identification of the most aggressive type II tumours.British journal of cancer · 2017Trial
- A case of small undifferentiated pancreatic carcinoma detected during follow-up for focal pancreatic parenchymal atrophy with fatty replacement.Clinical journal of gastroenterology · 2026Article
- A Clinical Score to Identify Individuals at High Risk of Pancreatic Cancer in the General Population.Diagnostics (Basel, Switzerland) · 2026Article
- Exploring correlations of CA19-9 with serum enzyme ratios: can layered biomarker strategies enhance prognostic accuracy in pancreatic cancer?Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- High-Dimensional Immunophenotyping of Plasma-Derived Small Extracellular Vesicles in Pancreatic Cancer: An Exploratory Proof-of-Principle Study.Biomolecules · 2026Article
- Identification of serum protein biomarkers for pre-cancerous lesions associated with pancreatic ductal adenocarcinoma.Molecular oncology · 2026Article
- Article
- Improving a Plasma Biomarker Panel for Early Detection of Pancreatic Ductal Adenocarcinoma with Aminopeptidase N (ANPEP) and Polymeric Immunoglobulin Receptor (PIGR).Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Article
- Analytical Validation of a Serum Biomarker Signature for Detection of Early-Stage Pancreatic Ductal Adenocarcinoma.Diagnostics (Basel, Switzerland) · 2025Article
- Confirmatory Clinical Validation of a Serum-Based Biomarker Signature for Detection of Early-Stage Pancreatic Ductal Adenocarcinoma.Current oncology (Toronto, Ont.) · 2025Article
- Cost-Effectiveness of Biomarker-Associated Early Pancreatic Cancer Detection in New-Onset Diabetes.JAMA network open · 2025Article
53 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
17 authors at 1 institution in 1 country.
Funding
Abstract
purposeBiomarkers for the early detection of pancreatic cancer are urgently needed. The primary objective of this study was to evaluate whether increased levels of serum CA19-9, CA125, CEACAM1, and REG3A are present before clinical presentation of pancreatic cancer and to assess the performance of combined markers for early detection and prognosis. EXPERIMENTAL
designThis nested case-control study within the UKCTOCS included 118 single and 143 serial serum samples from 154 postmenopausal women who were subsequently diagnosed with pancreatic cancer and 304 matched noncancer controls. Samples were split randomly into independent training and test sets. CA19-9, CA125, CEACAM1, and REG3A were measured using ELISA and/or CLIA. Performance of markers to detect cancers at different times before diagnosis and for prognosis was evaluated.
resultsAt 95% specificity, CA19-9 (>37 U/mL) had a sensitivity of 68% up to 1 year, and 53% up to 2 years before diagnosis. Combining CA19-9 and CA125 improved sensitivity as CA125 was elevated (>30 U/mL) in approximately 20% of CA19-9-negative cases. CEACAM1 and REG3A were late markers adding little in combined models. Average lead times of 20 to 23 months were estimated for test-positive cases. Prediagnostic levels of CA19-9 and CA125 were associated with poor overall survival (HR, 2.69 and 3.15, respectively).
conclusionsCA19-9 and CA125 have encouraging sensitivity for detecting preclinical pancreatic cancer, and both markers can be used as prognostic tools. This work challenges the prevailing view that CA19-9 is upregulated late in the course of pancreatic cancer development.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.