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Fecal elastase\u20101 (FE\u20101) is a widely used test to screen for EPI in cystic fibrosis (CF). Once thought permanent, some patients with EPI on CF transmembrane conductance regulator (CFTR)\u2010directed therapies (modulators) have been noted to show improvement in EPI. Here, we evaluated the utility of FE\u20101 in pwCF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>We performed a scoping review and searched several databases for the terms\/concepts of \u201ccystic fibrosis\u201d and \u201cfecal elastase\u20101\u201d and their synonyms. The search period was from 1\u20101\u20102003 to 7\u201031\u20102025. We included all age groups and used a web\u2010based platform for compiling and sorting out the articles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We combined the eligible studies to synthesize information on four questions: Utilization of FE\u20101 in CF (when to screen for EPI, how often to screen); Comparison of diagnostic accuracy of FE\u20101 versus other tests; Definition of ideal cut\u2010off for FE\u20101 in evaluating EPI in CF; Utilization of FE\u20101 in pwCF managed on CFTR\u2010directed therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>All pwCF should have EPI evaluated at diagnosis. Among various tests, FE\u20101 is the most commonly utilized test for screening EPI. A value of &lt;\u2009200\u2009\u03bcg\/g of stool is consistent with EPI and is highly sensitive for EPI diagnosis. A value of &lt;\u2009100\u2009\u03bcg\/g is highly specific for severe EPI. Repeating FE\u20101 should be considered in the current era of modulators, especially with a change in clinical status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71649","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T13:51:42Z","timestamp":1777989102000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Utility of Fecal Elastase\u20101 in Estimating Exocrine Pancreatic Function in Cystic Fibrosis: A Scoping Review"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3094-9703","authenticated-orcid":false,"given":"Senthilkumar","family":"Sankararaman","sequence":"first","affiliation":[{"name":"Cleveland Clinic Children's Hospital Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7089-7074","authenticated-orcid":false,"given":"Sara","family":"Hendrix","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy","family":"Neudecker","sequence":"additional","affiliation":[{"name":"UH Rainbow Babies and Children's Hospital Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3685-4078","authenticated-orcid":false,"given":"Drucy","family":"Borowitz","sequence":"additional","affiliation":[{"name":"Jacobs School of Medicine and Biomedical Sciences Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1938.01980140114013"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.52.8.1159"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(82)80501-5"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)82478-3"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004310000536"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2362.2001.00876.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.37042"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107689809134S07"},{"issue":"4","key":"e_1_2_9_10_1","first-page":"474","article-title":"Longitudinal Follow\u2010Up of Exocrine Pancreatic Function in Pancreatic Sufficient Cystic Fibrosis Patients Using the Fecal Elastase\u20101 Test","volume":"36","author":"Walkowiak J.","year":"2003","journal-title":"Journal of Pediatric Gastroenterology and Nutrition"},{"issue":"16","key":"e_1_2_9_11_1","first-page":"2","article-title":"Pathophysiology of the Exocrine Pancreas in Cystic Fibrosis","volume":"82","author":"Durie P. 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