What is the difference between anti-CCP and rheumatoid factor?

Both are antibodies seen in rheumatoid arthritis. Rheumatoid factor is older and less specific: it also appears with other conditions and with age. Anti-CCP is more specific for RA. Testing both gives a more accurate picture than RF alone, which is why clinicians usually order them together.

How accurate is the anti-CCP test?

Quest reports that about 70% of people with RA test positive, while only about 2% of blood donors and disease-control subjects do. That makes a positive result fairly specific, but a negative result does not rule RA out.

Can anti-CCP be positive before symptoms start?

Yes. In a Swedish study of blood donors who later developed RA, anti-CCP was already present in a third of samples taken before any joint symptoms, a median of about 2.5 years before onset. A positive result without symptoms is a reason to discuss monitoring with a clinician, not a diagnosis.

No. Quest lists no special preparation for this test. You can eat, drink and take your usual medicines.

How long do results take?

Quest's directory lists results in about 1 to 7 days after the sample reaches the lab, depending on which Quest laboratory runs it; most report within 2 to 4 days. Results appear in your private JustLabs dashboard.

What should I do if my result is positive?

Share it with a clinician, ideally a rheumatologist, especially if you have joint pain or swelling. They will examine your joints and may order imaging and inflammation markers. RA is diagnosed from the whole picture, and early specialist evaluation is worthwhile.

Does insurance cover it, and can I use my FSA or HSA?

JustLabs is a cash-pay service, so no insurance claim is filed. Lab tests are generally FSA/HSA-eligible, and JustLabs provides an itemized receipt you can submit; check with your plan administrator to confirm. Each order also includes one flat $18 Lab & Physician Order Fee, charged once per order no matter how many tests you add.

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🛡️ Autoimmune

Anti-CCP Antibody Test (Cyclic Citrullinated Peptide IgG)

Anti-CCP

Anti-CCP antibodies are found in most people with rheumatoid arthritis and rarely in people without it. Paired with rheumatoid factor, this test helps a clinician evaluate joint pain and stiffness that might be RA.

Rheumatoid arthritis (RA) is an autoimmune disease in which the immune system attacks the lining of the joints, causing pain, swelling and stiffness, often in the same joints on both sides of the body. Early evaluation matters, because the modern approach to RA focuses on recognizing it before lasting joint damage occurs.

Anti-CCP (cyclic citrullinated peptide) antibodies are autoantibodies against proteins that have been chemically modified by citrullination. Quest reports that about 70% of people with RA are positive for anti-CCP IgG, compared with only about 2% of random blood donors and disease controls. MedlinePlus notes that anti-CCP is more specific for RA than rheumatoid factor (RF).

The two tests are usually ordered together, because the combination is more informative than RF alone. Both are part of the serology domain of the 2010 ACR/EULAR rheumatoid arthritis classification criteria, alongside inflammation markers such as CRP and ESR. In a Swedish blood-donor study, anti-CCP was detectable years before RA symptoms began in some people who later developed RA.

This test is an immunoassay on serum, reported in units with negative, weak, moderate and strong positive bands. No fasting is needed. Results are informational and should be reviewed with a clinician.

Price

$29

All-in

$47

incl. $18 lab & physician fee

Results

1-7 business days

Fasting

Not Required

What's Measured

Cyclic citrullinated peptide (CCP) antibody, IgG

What This Test Measures

This test measures IgG antibodies against cyclic citrullinated peptide in your serum by immunoassay. Quest reports the result in Units: under 20 is negative, 20-39 weak positive, 40-59 moderate positive, and above 59 strong positive. Anti-CCP belongs to the family of anti-citrullinated protein antibodies (ACPA) used in RA classification.

Who Should Consider This Test

People with joint pain, swelling or morning stiffness that may be inflammatory, especially in the small joints of the hands and feet on both sides; people with a positive rheumatoid factor who want a more specific follow-up; and people with a family history of RA whose clinician is evaluating new joint symptoms.

Health Insights

Conditions Screened

Rheumatoid arthritisEarly or seronegative-RF rheumatoid arthritisEvaluation of inflammatory arthritis

Related Symptoms

Joint pain and swellingMorning stiffness lasting more than an hourPain in the same joints on both sidesSwollen finger or wrist jointsFatigueSkin nodules

When to Get Tested

When inflammatory arthritis is suspected, ideally together with rheumatoid factor and an inflammation marker such as CRP or ESR. Because anti-CCP is mainly a diagnostic marker, it is not usually repeated frequently once known. No fasting or timing around meals is needed.

No fasting needed. How to prepare for your blood test →

Understanding Your Results

A negative result (under 20 Units) makes RA less likely but does not exclude it, because roughly a third of people with RA do not have detectable anti-CCP. A positive result, especially moderate or strong, makes RA more likely when you have compatible joint symptoms. Per MedlinePlus, a positive anti-CCP with a positive RF means RA is probable; a positive anti-CCP with a negative RF may reflect early RA or a higher chance of developing it; and both negative make RA less likely, prompting a look for other causes. Anti-CCP can also occasionally appear in other conditions such as Sjogren's syndrome, lupus, active tuberculosis and chronic lung disease. Review your result with a clinician, usually a rheumatologist, who will consider your exam and other tests. JustLabs results are informational and are not a diagnosis.

What to Expect

After placing your order, we send it straight to Quest Diagnostics — there is no consent form to sign and no partner email to wait for. Your requisition is usually ready to download from your dashboard within about an hour, and you can book your blood draw at any Quest Diagnostics location.

The blood draw typically takes just a few minutes. Results are usually available within 1-7 business days and will appear in your secure JustLabs dashboard.

Our results include reference ranges and easy-to-understand indicators showing whether your values are within normal limits.

How much does the Anti-CCP test cost?

The Anti-CCP test costs $29 at JustLabs — $47 all-in, since the $18 lab & physician order fee is charged once per order, however many tests you add. The price is fixed before your blood draw; no insurance or doctor visit needed.