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Objectives: The purpose of this study was to assess the value of the serum levels of α-L-fucosidase activity in the diagnosis of patients with colorectal cancer. Methods: Using a fluorometric method we analyzed the α-L-fucosidase activity in preoperative sera from 137 colorectal cancer patients and in sera from 232 donors. Results: The enzymatic activity of α-L-fucosidase was significantly lower (p < 0.001) in patients (4.8 ± 3.09 U/ml) than in donors (10.5 ± 5.46 U/ml). Using the ROC curve, the ideal cut-off for the diagnostic value of α-L-fucosidase activity was determined to be 5.6 U/ml. The diagnostic efficiency for colorectal cancer of α-L-fucosidase activity was higher than that observed for carcinoembryonic antigen (cut-off 5.0 ng/ml), especially for tumors at an early stage. Conclusions: Our results suggest that preoperative serum α-L-fucosidase activity may be used as a cheap and easy complementary test, in addition to standard clinical procedures routinely used for the diagnosis of colorectal cancer.Copyright © 2000 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]