National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Pancreatic cancer

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My husband was treated for pancreatic cancer in 2011. He has been doing fine except for the fact that his CA 19-9 is elevated. He has had numerous tests with no explanation as to why the CA 19-9 has been on the rise now for about a year. His other blood tests seem normal. Is it possible he has some rare condition?

The following information may help to address your question:


What is CA 19-9?

The CA 19-9 is a tumor marker that is used along with other tests and procedures to help detect and diagnose cancer, monitor a person's response to treatment, and detect a recurrence. CA 19-9 levels are high in 70% to 90% of people with advanced pancreatic cancer, but high levels can also be due to a number of other conditions such as colorectal cancer, lung cancer, gallbladder cancer, gallstones, pancreatitis, cystic fibrosis and liver disease.[1] Healthy people often have small amounts of CA 19-9 as well. 

If CA 19-9 is elevated, your doctor may recommend additional tests, such as an CT scan, ultrasound, MRI, ERCP, and/or a biopsy.
Last updated: 4/2/2014

Can CA 19-9 be consistently increased in a person without cancer?

Yes. Cases of people with long lasting high levels of CA 19-9 with no evidence of cancer have been described in the medical literature. One common cause of highly elevated CA 19-9, not due to cancer, is cholestasis. Click here to visit MedlinePlus and learn more about cholestasis. Other reported cases have been due to interstitial pulmonary fibrosis, diabetes, endometriosis,[2] H. pylori infection,[3] and ruptured epidermoid cyst.[4] Medications may also play a role in elevated CA 19-9.[2] People with high levels of CA 19-9 and no signs of cancer, benefit from careful monitoring.[2] Talk with your doctor about setting a plan for follow-up.
Last updated: 4/2/2014

We hope this information is helpful. We strongly recommend you discuss this information with your doctor. If you still have questions, please contact us.

Warm regards,
GARD Information Specialist

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  1. CA 19-9. LabTestsOnline. November 29, 2012; http://labtestsonline.org/understanding/analytes/ca19-9/tab/faq. Accessed 4/2/2014.
  2. Ventrucci M, Pozzato P, Cipolla A, Uomo G. Persistent elevation of serum CA 19-9 with no evidence of malignant disease. Dig Liver Dis. 2009 May; 41(5):357-63. http://www.ncbi.nlm.nih.gov/pubmed/18602352. Accessed 4/2/2014.
  3. Ergül B, Sarikaya M, Dogan Z, Filik L. Extraordinarily elevation of CA 19-9 due to H. pylori infection. Clin Res Hepatol Gastroenterol. 2013 Sep; 37(4):e103-4. http://www.ncbi.nlm.nih.gov/pubmed/23806630. Accessed 4/2/2014.
  4. Inokuma T, Minami S, Suga K, Kusano Y, Chiba K, Furukawa M. Spontaneously Ruptured Giant Splenic Cyst with Elevated Serum Levels of CA 19-9, CA 125 and Carcinoembryonic Antigen. Case Rep Gastroenterol. 2010 Jun 11; 4(2):191-197. http://www.ncbi.nlm.nih.gov/pubmed/20805943. Accessed 4/2/2014.