Colorectal Adenoma-Cancer Pathology and Screening

Colorectal cancer typically arises through a multistep progression from benign adenomatous polyps to invasive carcinoma. Histopathological examination reveals that adenomas develop dysplasia characterised by architectural distortion and nuclear atypia. Key molecular events include activation of oncogenes such as KRAS and inactivation of tumour suppressor pathways, which together drive neoplastic transformation. Screening aims to detect and remove adenomas before they evolve into malignant lesions. Colonoscopy remains the gold standard, allowing direct visualisation and polypectomy, while less invasive modalities—faecal immunochemical tests, computed tomography colonography, and novel blood‐based biomarkers—extend reach and compliance. Emerging advances in optical diagnosis, artificial intelligence and enhanced contrast media promise to improve detection sensitivity, reduce miss rates and refine risk stratification. Globally, organised screening programmes have demonstrably lowered incidence and mortality, yet disparities in access and uptake persist. A comprehensive understanding of adenoma–carcinoma pathology underpins the optimisation of screening strategies and fosters the development of targeted preventive interventions.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Colorectal Adenoma-Cancer Pathology and Screening publication trend

The graph below shows the total number of articles in colorectal adenoma-cancer pathology and screening across all publications each year (not limited to Nature Index journals).

Technical terms

Adenoma: Benign glandular tumour of the colorectal mucosa that can develop dysplasia and progress to carcinoma.

Carcinoma: Malignant tumour arising from epithelial cells, such as those lining the colon and rectum.

Dysplasia: Abnormal cellular changes in the mucosa indicating premalignant transformation.

Polyp: An elevated lesion projecting into the lumen of the colon, often classified as neoplastic or non-neoplastic.

KRAS mutation: Genetic alteration in the KRAS gene leading to aberrant signalling and tumour progression in colorectal cancer.

Computer-aided diagnosis (CADx): The use of software algorithms to assist clinicians in interpreting medical images or endoscopic findings.

FDG PET/CT: Imaging technique combining positron emission tomography with 18F-fluorodeoxyglucose and computed tomography for functional and anatomical assessment of lesions.

References

1. Using Computer-aided Optical Diagnosis and Expert Review to Evaluate Colorectal Polyps Diagnosed as Normal Mucosa in Pathology. Clinical Gastroenterology and Hepatology (2024).
2. Use of Laxative-Augmented Contrast Medium Increases the Accuracy in the Detection of Colorectal Neoplasms. Diagnostics (2024).
3. Presence of activating KRAS mutations correlates significantly with expression of tumour suppressor genes DCN and TPM1 in colorectal cancer. BMC Cancer (2009).