CA 19-9: tumour marker in cancer of the pancreas, bile ducts and stomach

Q: What is CEA?

According to the NVKC, CEA, carcinoembryonic antigen, is another laboratory test a doctor often has done alongside CA 19-9 when cancer of the pancreas, bile ducts or stomach is suspected.

CA 19-9 is, according to the NVKC, a substance made mainly by cancer cells, and the NVKC finds moderate to very strong rises with cancer in the ducts of the pancreas that secrete digestive juices. According to the NVKC, those juices are needed to digest food such as fats and carbohydrates, and according to the NVKC, in 95% of cases of pancreatic cancer the tumour arises in that tissue.

According to the NVKC, a raised CA 19-9 also occurs with bile duct cancer and stomach cancer, and with a rise it is not immediately clear what type of cancer a patient has. Only a blood test shows how much CA 19-9 is in the blood.

Certe uses 0 to 34 k[arb'U]/L for everyone older than 18.

Doctor's Assessment Included

CA 19-9 is a tumour marker, a substance that according to the NVKC is made mainly by cancer cells. According to the NVKC, the test is used mainly to follow the effect of cancer treatment.

Star-SHL uses 0 to 37 U/ml, Unilabs 0 to 37 kU/l, Diagnostiek voor U below 37 kU/L and Certe 0 to 34 k[arb'U]/L for everyone older than 18.
According to the NVKC, a low CA 19-9 does not mean that someone has no cancer, because some people cannot make CA 19-9.
According to the NVKC, slight rises also occur in some healthy people, and temporarily with pancreatitis, gallstones, cystic fibrosis and liver diseases.

CA 19-9: what Dutch laboratories use

There is no nationally agreed reference value; this is what individual laboratories publish.

These 2 laboratories publish the same value: 37 ku/l.

Reference ranges by group, in ku/l
Laboratory	Group	Reference value (ku/l)	Relative scale
Star-shl	· Everyone	0–37 U/ml U/ml
Unilabs	· Everyone	0–37 kU/l	0 37
Certe	· Everyone · 18 years and older	0–34 k[arb'U]/L k[arb'U]/L
Diagnostiek voor U	· Everyone · a limit, not a range	< 37 kU/L	37

0 40.7 ku/l

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

CA 19-9: what this test measures

A CA 19-9 test measures the amount of CA 19-9 in the blood; Certe does so with an ECLIA based on the sandwich principle and reports the result in k[arb'U]/L, and Unilabs with a two-step immunometric immunoassay, in kU/l.

CA 19-9: why this value matters

According to the NVKC, with suspected cancer of the pancreas, the bile ducts or the stomach, CA 19-9 can help in making the diagnosis, usually together with imaging such as a CT scan or ultrasound.

CA 19-9: how the blood test works

Referral: No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw: A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Where: 650+ draw sites run by independent laboratories across the Netherlands. Draw sites

CA 19-9: when is testing worthwhile?

According to the NVKC, when a doctor suspects cancer of the pancreas, the bile ducts or the stomach, CA 19-9 is often measured together with CEA (carcinoembryonic antigen) or tests that give information about the liver, mainly with severe pain in the upper abdomen, nausea, weight loss and jaundice.

CA 19-9: symptoms of a high or low value

Low Levels

According to the NVKC, a low CA 19-9 result is no proof that there is no cancer, because some people do not make CA 19-9.

High Levels

According to the NVKC, a slight, temporary rise in CA 19-9 occurs with inflammation of the pancreas (pancreatitis), with gallstones, with cystic fibrosis and with liver diseases.

CA 19-9: causes of a low or high value

What lowers the value

Successful treatment of the tumour

After successful treatment or removal of the tumour, CA 19-9 can be lower than at the previous measurements; to establish that fall, it matters that the level was measured before the treatment.
Unable to make CA 19-9

Some people cannot make CA 19-9, which is why a low CA 19-9 does not mean that someone has no cancer.

What raises the value

Pancreatic cancer

Moderate to very strong rises in CA 19-9 are found with a certain type of pancreatic cancer: cancer in the ducts of the pancreas that secrete digestive juices.
Bile duct cancer or stomach cancer

Moderately to strongly raised CA 19-9 levels are found with bile duct cancer or stomach cancer.
Inflammation of the pancreas

With inflammation of the pancreas (pancreatitis), CA 19-9 can be slightly raised; the rise is temporary.
Gallstones

With gallstones, CA 19-9 can be slightly raised; the rise is temporary.
Liver diseases

With liver diseases, CA 19-9 can be slightly raised; the rise is temporary.

CA 19-9: lifestyle and this value

An abnormal CA 19-9 is a reason to talk to your GP. According to the NCI, a tumour marker is usually combined with other tests, such as imaging, to diagnose cancer.

CA 19-9: frequently asked questions

What is CEA?

According to the NVKC, CEA, carcinoembryonic antigen, is another laboratory test a doctor often has done alongside CA 19-9 when cancer of the pancreas, bile ducts or stomach is suspected.

CA 19-9: sources

Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
NVKC, Alles over testen: CA 19-9, allesovertesten.nl, geraadpleegd 2026-10-14 (retrieved 2026) allesovertesten.nl

Tests with related values

These panels measure values from the same category as this marker.

Prostate

Men Over 40 Panel

Age-appropriate screening including testosterone and PSA.

HbA1c (Glycated Hemoglobin) PSA (Prostate-Specific Antigen) ALT (Alanine Aminotransferase) TSH (Thyroid Stimulating Hormone) Triglycerides Creatinine Free T4 (Thyroxine) LDL Cholesterol SHBG (Sex Hormone Binding Globulin) Total Cholesterol Vitamin D (25-OH) Free Testosterone Total Testosterone hs-CRP (High Sensitivity CRP) HDL Cholesterol eGFR (Estimated Glomerular Filtration Rate) Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio

€279,-

Prostate