Faecal Calprotectin Levels In Cancer

David Muir

2 min read

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06-12-2024

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Faecal calprotectin is a protein found in the faeces. Its levels can be a useful indicator of intestinal inflammation, and increasingly, research is exploring its potential role in cancer detection and monitoring. While not a definitive diagnostic tool for cancer, elevated levels can warrant further investigation.

Understanding Faecal Calprotectin

Calprotectin is released by neutrophils, a type of white blood cell, during inflammation. In the gut, elevated levels are often associated with inflammatory bowel disease (IBD), such as Crohn's disease and ulcerative colitis. However, its presence can also be elevated in various cancers affecting the gastrointestinal tract, including colorectal cancer. It's important to understand that elevated levels don't necessarily mean cancer; many other conditions can cause increased calprotectin.

The Link Between Elevated Calprotectin and Cancer Risk

Several studies suggest a correlation between elevated faecal calprotectin levels and an increased risk of colorectal cancer. The presence of inflammation, indicated by high calprotectin, may create a microenvironment conducive to cancer development. However, the exact mechanisms are still being researched. The link isn't straightforward; some individuals with high calprotectin levels may never develop cancer, and conversely, some individuals with colorectal cancer may have normal or only slightly elevated levels.

Using Calprotectin in Cancer Screening and Monitoring

Currently, faecal calprotectin testing is not a primary screening tool for colorectal cancer. Colonoscopy remains the gold standard. However, it can be a valuable adjunct to existing screening methods. Specifically:

• Risk stratification: High levels can help identify individuals at increased risk who might benefit from more aggressive screening, such as earlier colonoscopies.
• Monitoring IBD patients: For patients with IBD, who are at a higher risk of colorectal cancer, monitoring calprotectin levels can help track disease activity and potential complications. Elevated levels might prompt closer monitoring or more frequent colonoscopies.
• Post-treatment surveillance: In some cases, tracking calprotectin levels after cancer treatment might help detect recurrence.

Limitations of Faecal Calprotectin Testing

It's crucial to acknowledge the limitations:

• Not cancer-specific: Many conditions, including infections and other gastrointestinal issues, can elevate calprotectin levels.
• False positives and negatives: The test can produce both false positive (elevated levels without cancer) and false negative (normal levels despite cancer) results.
• Not a standalone diagnostic: Elevated levels necessitate further investigation, typically with colonoscopy or other imaging techniques, to confirm a diagnosis.

Conclusion

Faecal calprotectin testing is a useful tool that aids in risk assessment and monitoring, particularly in individuals with IBD or a family history of colorectal cancer. While not a replacement for established cancer screening methods, it provides valuable information that can inform clinical decision-making. Further research continues to refine our understanding of its role in cancer detection and management. Always consult with a healthcare professional to interpret results and discuss appropriate next steps.