Advances in Early Detection of Colorectal Cancer: A Focus on Non-invasive Biomarkers

Abstract

Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer Worldwide. Currently, colonoscopy remains the gold standard diagnostic test for CRC detection. Nonetheless, this technique is invasive and expensive. Remarkable ongoing strategies are focusing on development affordable methods to diagnosis at earlier stages and surveille CRC. The introduction of suitable noninvasive, sensitive and specified diagnostic tests for early CRC detection by employing biomarker analysis seems to be a fundamental need to reduce the numbers of unnecessary colonoscopies. In this Review, we provide an overview of single- and multi-panel biomarkers (Genomic markers, transcriptome markers, proteomic markers, inflammatory markers and microbiome markers) encompassing noninvasive tests in blood and stool for early CRC detection. Methods: A bibliographic search using PubMed/Medline, Web of Science and EBSCOhost databases was performed to find relevant published studies over the last 6 years. Forty-three pertinent studies were included in this review. Results: The primary outcome highlights the sensitivity and specificity of single diagnostic biomarkers studied in blood or stool. The secondary outcome reveals the sensitivity and specificity of panel -biomarkers (combinations) in blood or stool. While some markers show better performance, other are not suitable for screening purposes. Conclusion: It remains to adjust experimental and analytical tests that can interfere à robust results to replace or supplement those currently markers in use. Even so, robust verification and validation with large clinical cohorts are needed to successful noninvasive tests that can fulfill the role of colonoscopy.

Non‐coding RNAs and colitis‐associated cancer: Mechanisms and clinical applications

“…For instance, stool or other bodily fluids, including urine and ascites, have been attracting attention as novel non‐invasive tools for CRC detection and monitoring. 128 , 129 , 130 Colorectal mucus is an important component of the protective intestinal barrier, and the loosened colorectal mucus may lead to severe disorders, including colitis and tumour initiation. Thus, this new method of colorectal mucus sampling can also provide highly informative material and present a simple and efficient method for IBD detection.…”

“…First, in addition to the information from blood or colon tissues, we still need to focus on some other sources of clinical samples. For instance, stool or other bodily fluids, including urine and ascites, have been attracting attention as novel non‐invasive tools for CRC detection and monitoring 128–130 . Colorectal mucus is an important component of the protective intestinal barrier, and the loosened colorectal mucus may lead to severe disorders, including colitis and tumour initiation.…”

Association of β-Catenin, APC, SMAD3/4, Tp53, and Cyclin D1 Genes in Colorectal Cancer: A Systematic Review and Meta-Analysis

“…Several susceptibility studies on the association of a genetic variant and CRC have been reported [ 5 ]. The solid tumors of CRC have served as genetic and biological paradigms and instigated to conduct studies on early detection [ 6 ], prevention [ 7 ], risk stratification [ 8 ], and treatments [ 9 ]. However, a greater understanding and identification of genetic biomarkers involving molecular and genetic pathways with improved sensitivity and specificity could improve screening for and expedite the diagnosis of CRC, yielding better outcomes.…”