Preferred Sample Type

Cancer Antigen 19-9 (CA 19-9)

Suitable Specimen Types

  • Serum
5-10 mL vacutainer (minimum sample volume 200 uL)

Specimen Transport

Usual transport to laboratory.

Sample Preparation

Centrifuge and separate serum. Store serum at 4ºC prior to analysis and for transport to referral laboratory

Turnaround Time

7 days

Sample Stability

Stable at 4 ºC for up to thirty days

Cancer Antigen 19-9 (CA 19-9)

General Information

Carbohydrate Antigen CA 19-9 is a high molecular weight mucin containing a sialylated Lewis pentasaccharide epitope which is elevated in most pancreatic adenocarcinomas, approximately 50% of gastric carcinomas and approximately 30% of colorectal carcinomas.

Several benign diseases including chronic and acute pancreatitis, liver cirrhosis, cystic fibrosis and cholecystitis may give rise to selevated CA 19-9 levels. Very high values (>5,000 kU/L) have been seen in patients with obstructive jaundice due to cholelithiasis.

CA 19-9 is primarily used for monitoring patients with pancreatic cancer. Serial measurements of CA 19-9 every 1 – 3 months, together with imaging, should be used to monitor patients with pancreatic cancer with locally advanced or metastatic disease who are receiving therapy. Increases suggest progressive disease but confirmation from other investigations should be sought.

CA 19-9 should not be used to screen for pancreatic or any other GI Cancer.

Patient Preparation

Samples from patients receiving high biotin doses (i.e. >5 mg/day) should be taken at least 8 hours post dose.

Please inform the laboratory if the patient has been treated with monoclonal mouse antibodies or may have received them for diagnostic purposes.


Samples should be clot free and free of red blood cells or other particulate matter. The presence of fibrin may cause erroneous results.

From 04.10.2021 CA19-9 will be analysed by the Abbott Alinity method at the Queen Elizabeth Hospital site..

Pathology Harmony have published guidance on appropriate tumour marker requesting.  For information please click on the following link:

If you would like some copies of the bookmark please contact the Duty Biochemist (bleep 2506).

Reference Range

<37U/mL (Source: Abbott Kit insert)



  • EQA Scheme?: Yes
  • EQA Status: UKNEQAS for tumour markers

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The Trust Laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital were awarded UKAS (United Kingdom Accreditation Service) accreditation to the internationally recognised ISO 15189 standard in May 2015. For a list of accredited tests and other information please visit the test database
Tests not appearing on this scope are either under consideration or in the process of accreditation and so currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.

For further information contact Louise Fallon, Quality Manager, 0121 424 1235