Blood-based biomarkers for early detection of colorectal cancer

Abstract

Most sporadic colorectal cancers develop from adenomas over many years. Colorectal cancer is potentially curable if detected at an early stage; the 5-year survival rate for colorectal cancer is approximately 91% for localized disease. In addition, high-risk colorectal adenomas and intramucosal colorectal cancers have the potential to undergo curative endoscopic resection. Therefore, early detection of colorectal cancer, including colorectal adenomas, is an attractive approach to overcome colorectal cancer. Fecal immunochemical test (FIT) is currently used as a screening modality for colorectal cancer. However, due to the high false-positive rate and insufficient sensitivity of FIT for early-stage colorectal cancer and high-risk colorectal adenomas, there is an urgent need to develop a simple and more accurate early detection test for colorectal cancer. The rich content of blood with diverse molecular elements and cellular constituents—such as circulating free DNA, proteins, autoantibodies, microRNAs, and extracellular vesicles—provides an ideal compartment to develop noninvasive diagnostics for cancers originating from various organs. This paper outlines the current status and future perspectives of early detection of colorectal cancer using blood-based biomarkers.