Screening for colorectal cancer: established and emerging modalities.

Area of Science:

• Oncology
• Molecular Diagnostics
• Cancer Screening

Background:

• Over 95% of colorectal cancer (CRC) cases could benefit from curative surgery if diagnosed early.
• Current CRC screening methods (colonoscopy, fecal occult blood tests) have limitations in cost-effectiveness and accuracy.
• Population screening programs primarily target individuals over 50-60 years old.

Purpose of the Study:

• To critically evaluate the performance and merits of emerging molecular diagnostic markers for colorectal cancer (CRC).
• To assess the potential of novel stool and blood-based biomarkers for CRC screening.
• To compare new molecular methods against conventional CRC screening approaches.

Main Methods:

• Review of performance data for various molecular diagnostic methods for CRC.
• Evaluation of stool-based tests (DNA mutations, epigenetic changes, microRNA).
• Assessment of blood-based tests (plasma DNA, microRNA, transcriptome, proteins, autoantibodies).

Main Results:

• Numerous molecular markers in stool and blood show potential for CRC detection.
• These novel methods are currently in early stages of development (proof-of-principle, pilot studies).
• Existing screening modalities remain the standard for population-based CRC detection.

Conclusions:

• Molecular markers offer promising avenues for future colorectal cancer (CRC) screening.
• Further large-scale validation is necessary before these new methods can replace current screening strategies.
• Widespread clinical adoption of molecular CRC diagnostics is likely several years away.