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CA 19-9 is the principal serum biomarker for pancreatic ductal adenocarcinoma (PDAC) — us...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDBMA-CA-19-9-PANCREATIC-CAPS-SURVEILLANCE
TypeActionability
Statusreviewed 2026-05-18 | actionability review required
DiseasesDIS-PDAC
SourcesSRC-CAPS-CONSORTIUM-PANCREATIC-2020 SRC-ESMO-PANCREATIC-2024 SRC-NCCN-PANCREATIC-2025

Actionability Facts

BiomarkerBIO-CA-19-9-PANCREATIC
VariantCA 19-9 — PDAC surveillance / treatment-response monitoring
DiseaseDIS-PDAC
ESCAT tierIIIA
Recommended combinationsRising CA 19-9 + new EUS / MRCP findings in high-risk carrier: refer to multidisciplinary pancreas centre for biopsy / staging, Treatment response: declining CA 19-9 >50% by mid-treatment supports continuation; rising despite therapy → restage
Evidence summaryCA 19-9 is the principal serum biomarker for pancreatic ductal adenocarcinoma (PDAC) — used for (a) prognosis at diagnosis, (b) treatment response monitoring (declining CA 19-9 during neoadjuvant / systemic therapy correlates with PFS / OS — Tempero 2024), and (c) longitudinal surveillance in high-risk germline carriers per the CAPS Consortium 2020 (CDKN2A, BRCA1/2, PALB2, ATM, STK11, MMR with positive FH; PRSS1 mutation with hereditary pancreatitis). CA 19-9 is NOT useful for population screening — high false-positive rate and Lewis-antigen-negative non-secretors (~5-10%) lack the epitope. In the CAPS surveillance pathway, rising CA 19-9 combined with EUS/MRI findings triggers further workup. ESCAT IIIA.

Notes

STUB pending two-Co-Lead signoff. Hereditary-PDAC surveillance Indication entities for CAPS-cohort syndromes (CDKN2A/FAMMM, BRCA1/2, PALB2, ATM, Lynch, STK11, hereditary pancreatitis) are partially authored — closest existing entities: ind_brca_carrier_surveillance, ind_fammm_carrier_surveillance, ind_lynch_carrier_surveillance. A dedicated IND-CAPS-COHORT-SURVEILLANCE entity (consolidating the trigger criteria across syndromes) is a future authoring task. Lewis-antigen-negative status (~5-10% of population) yields false-negative CA 19-9 — this should be flagged in the patient profile to avoid false reassurance. Engine should not surface CA 19-9 < ULN as "negative" without Lewis status known.

Used By

No reverse references found in the YAML corpus.