TOPLINE:

Faecal calprotectin (FC) levels were significantly higher in children with colorectal polyps than in those with normal colonoscopy findings, suggesting a potential as a screening tool.

METHODOLOGY:

• Researchers conducted a retrospective observational study at Children's Hospital Zagreb to assess the potential role of FC as a screening biomarker in children who underwent colonoscopy between November 2013 and December 2023.
• The analysis included children with one or more polyps requiring polypectomy who were matched with control children with normal colonoscopy findings.
• After matching, 95 colonoscopies with polyps were compared with 380 matched control colonoscopies with normal findings.
• The primary outcome was the measurement of the FC cutoff level indicative of the presence of polyps; secondary outcomes evaluated correlations between FC levels and polyp characteristics.

TAKEAWAY:

• FC levels were higher in patients with polyps than in those with normal colonoscopy findings (P = .009).
• FC showed an area under the curve of 0.727 (95% CI, 0.648-0.807), with a cutoff level of 20.5 μg/g providing a sensitivity of 90% and a cutoff level of 741 μg/g achieving a specificity of 90%.
• Only 3% of patients with polyps showed FC levels below the laboratory cutoff value of 20 μg/g.
• No significant correlations were found between FC levels and polyp size, histologic characteristics, polyp location, or whether the polyp was solitary or a part of a polyposis syndrome.

IN PRACTICE:

"Carefully weighing which patients truly require colonoscopy is crucial, as demonstrated by our study, FCP [faecal calprotectin] is an important discriminator," the authors wrote.

SOURCE:

This study was led by Anita Kolobarić, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina. It was published online on October 07, 2025, in the European Journal of Pediatrics.

LIMITATIONS:

This study was limited by its retrospective design, the lack of age-specific reference values of FC, and the absence of a comparison of FC levels with other causes of rectal bleeding, and the measurement of polyp size using the maximum length of the specimen rather than the surface area or volume may have affected the association with FC levels.

DISCLOSURES:

No funding information was provided for this study. Two authors reported receiving honoraria for lectures and one of them reported receiving travel expenses from various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.