LAUSR

Faecal calprotectin (FC) and the faecal immunochemical test for haemoglobin (FIT) are recommended for use in primary care where colorectal cancer (CRC) is not suspected.1 2 We are unclear how best to use these two biomarkers in younger patients where lower gastrointestinal symptoms are extremely common. Distinguishing irritable bowel syndrome from inflammatory bowel disease (IBD) from CRC on clinical grounds is often an uncertain exercise. Currently, there is no direct comparative evidence base on which to identify the optimal use of each biomarker. We undertook an illustrative comparison of the diagnostic accuracy of FC in a patient dataset at ‘low risk’ of CRC stratified by age and symptoms, and of FIT, from three existing published studies that included both CRC and IBD in their outcomes.3–11 From an existing dataset of patients using the York Faecal Calprotectin Care Pathway (YFCCP), we identified 1919 patients fulfilling National Institute for Health and Care Excellence (NICE) DG30 criteria. …