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CA19-9 is elevated in blood, primarily in patients with carcinoma of the gastro-intestinal tract. Higher levels are more likely to be due to malignancy than lower levels, however very high levels are occasionally seen in patients with benign conditions such as cirrhosis. CA19-9 is not sufficiently specific for use as a screening test, its greatest usefulness is with pancreatic cancer compared with pancreatitis. The specificity for pancreatic cancer increases with increasing levels, high levels showing a specificity of >97%.