Kemper M, Hentschel W, Graß JK, et al. - Whether preoperative serum midkine level (S-MK) can afford a suitable marker for screening colorectal carcinoma (CRC) and whether S-MK correlates with tumor progression and localization, were determined in this prospective single-center study. Researchers also determined, for the first time, if poor survival is experienced by patients with high S-MK. This study was performed on 299 patients with CRC. Significantly high S-MK was detected in patients with CRC. The receiver operation characteristic curve had an area under the curve of 0.868. Sensitivity and specificity of 84.3% and 75.4%, respectively, were yielded at a cut-off value of 56.42 pg/mL. No significant correlations between S-MK and tumor progression, localization, were revealed in the one-way analysis of variance. It was shown in the Kaplan-Meier survival analysis, for the first time, that a significantly shorter survival was experienced by patients with S-MK of more than 225 pg/mL. Only carcinoembryonic antigen was identified as an independent prognostic factor for survival, on multivariate Cox regression. The utility of S-MK in aiding the estimation of the prognosis for CRC as well as its value as a component for developing a multimarker panel for screening and surveillance were suggested.