Diagnostic value of faecal calprotectin in unselected outpatients referred for colonoscopy: A multicenter prospective study

Dig Liver Dis. 2010 Mar;42(3):191-5. doi: 10.1016/j.dld.2009.07.002. Epub 2009 Aug 19.


Objectives: To evaluate the role of faecal calprotectin in consecutive outpatients referred for colonoscopy.

Methods: Outpatients undergoing colonoscopy at five participating institutions were eligible. Demographic and clinical data were collected. Faecal samples were tested at a single laboratory by means of a commercially available kit.

Results: We consecutively enrolled 870 patients. Mean levels of calprotectin were significantly higher in patients with neoplastic and inflammatory disorders when compared with subjects with a normal colonoscopy or trivial endoscopic findings. Elevated calprotectin levels (>50mg/dl) were detected in 85% of patients with colorectal cancer, and 81% of those with inflammatory conditions but also in 37% of patients with normal or trivial endoscopic findings. In patients referred for chronic diarrhoea, sensitivity and negative predictive value were 100% in detecting either any organic colonic disease. In patients referred for symptoms of "suspected functional origin" sensitivity and negative predictive value for colorectal cancer were also 100%.

Conclusions: In unselected outpatients referred for colonoscopy, a single measurement of faecal calprotectin is not sufficiently accurate to identify those with significant colorectal disease. However, a normal result can help rule out organic disease among patients with diarrhoea and those with abdominal pain and/or constipation.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Abdominal Pain / etiology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / analysis
  • Colonic Polyps / diagnosis*
  • Colonoscopy
  • Colorectal Neoplasms / diagnosis*
  • Constipation / etiology
  • Diarrhea / etiology
  • Feces / chemistry*
  • Female
  • Gastroenteritis / diagnosis*
  • Humans
  • Leukocyte L1 Antigen Complex / analysis*
  • Male
  • Middle Aged
  • Outpatients
  • Predictive Value of Tests
  • Prospective Studies
  • Young Adult


  • Biomarkers
  • Leukocyte L1 Antigen Complex