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Tumor Markers

CA 19-9: a tumour marker that can also be followed in ovarian, breast and uterine cancer

According to the NVKC, cancer cells mainly make the substance CA 19-9, a tumour marker, and when CA 19-9 is released from the cell it can end up in the blood. According to the NVKC, CA 19-9 is measured mainly to follow the effect of therapy, for example in cancer of the pancreas, bile ducts, stomach, bowel, ovary, lung, breast or uterus.

The NVKC finds moderate to very strong rises with a certain type of pancreatic cancer, among others, but according to the NCI, not everyone with a raised tumour marker has cancer. Only a blood test shows the amount of CA 19-9.

Star-SHL uses 0 to 37 U/ml for CA 19-9.

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
Star-shl · Everyone 0–37 U/ml
Unilabs · Everyone 0–37 kU/l
0 37
Certe · Everyone · 18 years and older 0–34 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

Star-SHL measures how much CA 19-9, cancer antigen 19-9, is in the blood with an electrochemiluminescence immunoassay (ECLIA), in U/ml; according to the NVKC, the reference values differ per laboratory.

CA 19-9: why this value matters

In a patient whose CA 19-9 was already raised before treatment, the doctor can measure CA 19-9 regularly, according to the NVKC: according to the NVKC, a fall fits a working therapy, and a rise fits cancer that comes back or grows further.

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, a doctor measures CA 19-9 mainly to find out whether a cancer treatment is working, or to check whether a tumour comes back after treatment.

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

Low Levels

According to the NVKC, a fall in CA 19-9 compared with earlier measurements can follow successful treatment or removal of the tumour, and for that, according to the NVKC, it matters that the doctor measured the level before the treatment.

High Levels

According to the NVKC, raised CA 19-9 levels occur in patients with gallbladder cancer or colon cancer, as well as with a certain type of pancreatic cancer, bile duct cancer and stomach cancer. The NVKC also sees slight, stable rises in some healthy people.

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

Discuss an abnormal CA 19-9 with your GP. According to the NCI, to diagnose cancer a doctor usually uses a tumour marker together with other tests, such as a biopsy or a scan.

CA 19-9: frequently asked questions

Is CA 19-9 also measured in ovarian cancer?

Yes, the NVKC names cancer of the ovary among the kinds of cancer in which CA 19-9 can follow the effect of therapy. For ovarian cancer, the NCI names another tumour marker, CA-125.

CA 19-9: sources

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

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