This analysis measures the concentration of the tumor form (M2) of the pyruvate kinase enzyme (Tumor M2-PK) in a stool sample. This enzyme is found in high concentrations in rapidly dividing and cancerous cells, where it converts glucose metabolism to anaerobic metabolism (Warburg effect). Elevated levels of this enzyme in stool indicate abnormal proliferative activity in the colonic and rectal mucosa, which may be due to malignant tumors or precancerous (pre-cancerous) adenomas.