Faecal calprotectin or FIT (faecal immunochemical test)

NICE have recommended the use of faecal calprotectin to distinguish between inflammatory bowel disease and functional gut disorders (1)

• calprotectin is to be used according to local pathways and when cancer is not suspected
  
  
• NICE give no clear advice on when to use calprotectin and when to use the faecal immunochemical test (FIT) (2)
  
  
• in one study with patients of median age 67 (Widlack) (3), there was no advantage to adding calprotectin to FIT (in the detection of colorectal cancer) but they have not been formally compared in younger age groups
  
  
• "it seems reasonable to use calprotectin in patients under 40 years of age, either calprotectin or FIT between 40 and 50 and FIT in those over 50" (4)

Contributor:

Dr Mark Welfare

• Community gastroenterologist with Northumberland CCG and clinician with Northumbria Trust

Reference:

• NICE (October 2013). Faecal calprotectin diagnostic tests for inflammatory diseases of the bowel
• NICE (July 2017). Quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care
• Widlak et al. Undetectable faecal immunochemical test for haemoglobin excludes colorectal cancer in symptomatic patients: a prospective uk study. Aliment Pharmacol Ther. 2017 Jan;45(2):354-36
• Personal Communication (4/12/18). Dr Mark Welfare, Community Gastroenterologist Northumberland CCG.