Fecal Calprotectin & CRC

[nowayoutofthis1]

Hey all, I am waiting on a colonoscopy I have scheduled for June 27th due to some symptoms and have a question for you all. Did any of you that got a CRC diagnosis have a really low fecal calprotectin score? I have been worried (as we all are) about what will be found on this colonoscopy, but I had a FC test come back at 8 (normal 5 - <50) and from everything I have read, a low FC score (< 40) seems to have a negative predictive value (NPV) for CRC of between 97-99%, link below. Some of my symptoms have gone away since calming down and this FC score has given me a lot of hope that perhaps this is going to be something other than CRC, so was curious as to what you all (if any) had with experience with your FC level prior to a diagnosis. The only exceptions I have read are it missed a few rectal cancers due to how low in the colon they were, but I do not think that applies to me as my symptoms don't seem to correlate with rectal cancer. I know no one is a doctor and cannot give advice, just asking for others experiences. Thanks!

bmcgastroenterol.biomedcent...

[Hidden]

I had this test prior to colonoscopy but the gastroenterologist recommended the colonoscopy and endoscopy. I think the calprotectin is a marker for potential conditions so it may not be specific for one thing or another. My result was under 10. Your pending colonoscopy will be a visual test of the bowel. My colonoscopy showed some bad diverticulitis disease and endoscope found some significant gastric problems. I think they call these scopes 'gold standard' and despite the fact that I had all red flags for bowel cancer, it was not the case. Your scope is soon and you will have answers. Best wishes.

[nowayoutofthis1 in reply to Hidden]

Yep understood, I am still getting the colonoscopy. I do think though that the really low fecal calprotectin level I have gives me good hope that this is not going to be a CRC diagnosis with the high NPV that this level reflects.

[GCCA-Survivor Administrator]

Hi nowayoutofthis1,

Interesting article. I am glad they are looking for any correlations that may be indicative of CRC. Especially one that may be used as a screening tool and is non-invasive. But for the known high risk, we get the colonoscopy. And even if it was indicative of CRC, it may well be IBD, ulcerative colitis, or Crohn’s as well. So, probably a colonoscopy is warranted.

In my case, I presented at stage 4. I’m not sure if a FC was performed at that point.

Like Tony11173 said, you’ll have some good answers soon. I think your FC score can give you hope of something other than CRC.

Please let us know what you find out from your procedure on the 27th.

My colonoscopy 2 cents … move the timeline up 2-3 hours on everything prep wise. This way the prep “wave” will be over sooner and you can get a good night’s sleep. Do the same for the next day. Also, flavor to the prep mix with Gatorade (nothing red, there are many flavor packets to choose from) and add more water if you want to thin it out a bit.

healthy.kaiserpermanente.or...

Gook luck and positive vibz your way for definitive answers.👍

Tom

[nowayoutofthis1 in reply to GCCA-Survivor]

Yes, I am still getting the colonoscopy. I am just stating in light of the new research that the low FC reading gives some hope that the diagnosis will be something other than CRC, especially late stage CRC. It really helps to provide some mental relief while you are waiting on the colonoscopy.

[nowayoutofthis1]

Okay, so update. I had my colonoscopy done today. Not going to lie, I was terrified I was going to be told I had cancer after the procedure. By far the worst part is the prep and mine really wasn't all that bad, seems people like to exaggerate.

Two sessile polyps of benign appearance were removed, 4 to 8mm, from ascending and traverse colon. Also grade 1 internal hemorrhoid, otherwise colon was normal looking. No cancer was found!

For those who may come across this in the future, perhaps this will give you some peace while you are awaiting diagnosis if you happen to get a fecal calprotectin test. I know those in the UK probably don't get them as much on the 2WW pathway, but in the US it might be more common. It has a really high negative predictive value for colon cancer and seems it held true for me. Below is the link to an article from 2022 on a research paper done from the University of Glasglow in Scotland that provides a lot of information gathered from many other studies. It seems to be a relatively new area of research, but also looks promising. I hope it helps bring anxiety relief for some that may run across this in the future. Good luck on your journey!

bmcgastroenterol.biomedcent...

[sandylo in reply to nowayoutofthis1]

You were one of the lucky ones with your colonoscopy mine was worse than being in a torture chamber and had to be aborted I went back a month later and had it done again under propofol to take the rest of a 22mm sessile polyp away they had perforated my colon I would sooner die than go through that again and I am a tough person had both my children at home and never went to the doctors till I was 8 months pregnant. I have never been right since and housebound now due to leaking bowel