American Board of Internal Medicine (ABIM) Certification Practice Exam

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What biomarker is routinely measured preoperatively in colorectal cancer patients?

Serum alkaline phosphatase
Serum carcinoembryonic antigen (CEA) levels
Serum prostate-specific antigen (PSA) levels
Complete blood count

The correct answer is: Serum carcinoembryonic antigen (CEA) levels

The measurement of serum carcinoembryonic antigen (CEA) levels is routinely performed preoperatively in colorectal cancer patients due to its significance as a tumor marker specifically associated with this type of cancer. CEA is a glycoprotein involved in cell adhesion and is typically elevated in individuals with colorectal cancer. Assessing CEA levels can help in several ways: it can aid in the diagnosis of colorectal cancer, provide information about the extent of disease, and serve as a prognostic indicator. Elevated preoperative CEA levels often correlate with more advanced disease and can be used to monitor treatment response or disease recurrence postoperatively. Other biomarkers mentioned, such as alkaline phosphatase and complete blood count, do provide useful information in clinical practice but are not specific to colorectal cancer diagnostics. Serum prostate-specific antigen (PSA) is primarily used for prostate cancer screening and monitoring, making it irrelevant in the context of colorectal cancer. Thus, CEA is the principal and most relevant biomarker utilized in the preoperative evaluation of colorectal cancer patients.