Physiological influences that need to be considered in interpreting the results include effects of aging and menopause; metabolism and route-of-elimination kinetics of the tumor marker; coexisting disease, like renal or liver failure; hormonal imbalances, like hyperthyroidism/ hypothyroidism; etc.[20, 21] Life-style influences on tumor marker values include states like smoking (increases levels of CEA, AFP, etc.), alcoholism (altered liver and renal parameters), obesity (hormonal imbalances, altered steroidal metabolism in peripheral fat), etc. This evidence concerns the gene CEACAM5 and neoplasm.