Recent Developments in Diagnostic and Prognostic Biomarkers for Colorectal Cancer: A Narrative Review

Abstract

Colorectal cancer was reported as the second most common cause of cancer death worldwide, in the year 2020. This disease is an important public health problem considering its high incidence and mortality rates. The molecular events that lead to colorectal cancer include genetic and epigenetic abnormalities. Some of the most important molecular mechanisms involved include the APC/β-catenin pathway, the microsatellite pathway and the CpG island hypermethylation. Evidence in the literature supports a role for the microbiota in the development of colon carcinogenesis and specific microbes may contribute to or prevent carcinogenesis. Progress in prevention, screening and management have improved the overall prognosis of the disease when diagnosed at an early stage; yet metastatic disease continues to have a poor long-term prognosis due to late-stage diagnosis and treatment failure. Biomarkers are a key tool for early detection and prognosis and aim to reduce morbidity and mortality associated with colorectal cancer. The main focus of this narrative review is to provide an update on the recent development of diagnostic and prognostic biomarkers in stool, blood and tumour tissue samples. The review focuses on recent investigations in micro-RNAs, cadherins, piwi-interacting RNAs, circulating cell free DNA and microbiome biomarkers which can be applied for the diagnosis and prognosis of colorectal cancer.