Evidence map›Paper›PMID 41957956›Full record

ArticleInternational journal of cancer2026

Head-to-head comparison of the diagnostic value of fecal and serum carcinoembryonic antigen for colorectal cancer detection.

Xianzhe Li, Zitong Zhao, Lara Stassen, Anjana Pradeep Maya, Megha Bhardwaj, Teresa Seum, Janhavi R Raut, Tafirenyika Gwenzi, Michael Hoffmeister, Petra Schrotz-King and 1 more

Abstract readComparative Study
In one paragraph

Article in International journal of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Xianzhe LiDivision of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID https://orcid.org/0000-0002-7991-6884
Zitong ZhaoDivision of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Lara StassenNational Center for Tumor Diseases (NCT), NCT Heidelberg, a Partnership Between DKFZ and University Hospital Heidelberg, Heidelberg, Germany.
Anjana Pradeep MayaNational Center for Tumor Diseases (NCT), NCT Heidelberg, a Partnership Between DKFZ and University Hospital Heidelberg, Heidelberg, Germany.
Megha BhardwajDivision of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Teresa SeumDivision of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID https://orcid.org/0009-0003-4475-0583
Janhavi R RautMedical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.ORCID https://orcid.org/0000-0001-6537-8598
Tafirenyika GwenziDivision of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Michael HoffmeisterDivision of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID https://orcid.org/0000-0002-8307-3197
Petra Schrotz-KingNational Center for Tumor Diseases (NCT), NCT Heidelberg, a Partnership Between DKFZ and University Hospital Heidelberg, Heidelberg, Germany.
Hermann BrennerDivision of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.

Funding

Federal Ministry of Education and Research BMBF,01KD2104A
6 · The paper itself

Abstract

This study aimed to conduct a head-to-head comparison of the diagnostic value of serum carcinoembryonic antigen (sCEA) and fecal CEA (fCEA) for colorectal cancer (CRC) detection. Fecal and serum samples from 80 CRC cases at various tumor stages and 100 controls free of colorectal neoplasms at screening colonoscopy were randomly selected from two ongoing large prospective CRC detection studies (IDA and BLITZ) for CEA measurements. Fecal samples were processed using two methods: with and without mechanical homogenization. Diagnostic performance (area under the curve value [AUC], sensitivity) of fCEA and sCEA was compared individually and in combination with fecal immunochemical test (FIT). The fCEA concentrations obtained using both sample processing methods were highly correlated in both CRC cases and controls, but neither correlated with sCEA. The sCEA concentrations demonstrated significantly greater differences between the CRC and control group compared to fCEA concentrations. The diagnostic performance of fCEA obtained with both fecal sample processing methods was significantly lower than that of sCEA (AUC: 0.62 and 0.57 vs. 0.83, both p < .001; sensitivity at 85% specificity: 36.2% and 26.2% vs. 52.5%, p = .067 and .002). Algorithms combining sCEA with fCEA did not significantly improve the diagnostic performance compared to sCEA alone. Combining FIT with sCEA improved diagnostic performance over FIT alone. However, combining FIT with fCEA showed no improvement. In conclusion, fCEA is inferior to sCEA as a non-invasive biomarker for CRC detection. Combination of FIT with sCEA demonstrates greater potential for CRC screening than combination of FIT with fCEA.

Indexed as

Biomarkers, TumorCarcinoembryonic AntigenColorectal NeoplasmsFecesAgedCase-Control StudiesEarly Detection of CancerFemaleHumansMaleMiddle AgedProspective StudiesSensitivity and SpecificityBiomarkers, TumorCarcinoembryonic Antigenbiomarkercarcinoembryonic antigencolorectal cancerdetection

Identifiers

PMID41957956
PMCPMC13193527

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Registered trials

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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.