Colorectal Cancer Detection and Screening Techniques
Summary
Colorectal cancer remains a major contributor to cancer mortality worldwide, yet its long preclinical phase offers abundant opportunity for early intervention. Screening programmes aim to identify precancerous lesions or early-stage tumours before symptoms arise, reducing both incidence and mortality. The gold standard remains colonoscopy, which allows direct visualisation, biopsy and removal of polyps, but its invasive nature, requirement for bowel preparation and associated costs drive the development of alternative approaches. Flexible sigmoidoscopy, computed tomography colonography and capsule endoscopy permit less invasive colonic evaluation, while stool-based tests detect occult blood or tumour-derived DNA and epigenetic markers. Blood-based assays target circulating tumour DNA, methylated gene fragments or protein biomarkers. Emerging liquid-biopsy techniques harness cell-free DNA and advanced molecular assays to enhance sensitivity and specificity. Optimal screening strategies integrate patient risk factors, resource availability and test performance to deliver personalised surveillance intervals and maximise uptake in diverse healthcare settings.
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Colorectal Cancer Detection and Screening Techniques publication trend
The graph below shows the total number of articles in colorectal cancer detection and screening techniques across all publications each year (not limited to Nature Index journals).
Technical terms
Colonoscopy: Endoscopic examination of the entire colon and rectum, allowing direct visualisation, biopsy and removal of lesions.
Computed tomography colonography (CTC): Radiological imaging of the colon performed with CT scanning and specialised software, offering a non-invasive virtual colonoscopy.
Faecal immunochemical test (FIT): Quantitative immunoassay that detects human haemoglobin in stool as an indicator of bleeding lesions in the lower gastrointestinal tract.
Circulating cell-free DNA (cfDNA): Fragments of DNA released into the bloodstream by apoptotic or necrotic cells, used in liquid-biopsy assays to detect tumour-specific alterations.
DNA methylation: Epigenetic modification involving addition of methyl groups to cytosine bases within CpG dinucleotides, often altered in cancer cells.
Polymerase chain reaction (PCR): Molecular biology technique for exponential amplification of targeted DNA sequences, enabling sensitive detection of genetic or epigenetic markers.
References
- Current positions regarding the diagnosis and screening of colorectal cancer and precancerous changes of bowel. Analysis of clinical cases. Gastroenterology (2024).
- Early Diagnosis of Colorectal Cancer Based on Bisulfite‐free Site‐specific Methylation Identification PCR Strategy: High‐Sensitivity, Accuracy, and Primary Medical Accessibility. Advanced Science (2024).
- Pan‐cancer analysis of genome‐wide methylation profiling discover type‐specific markers targeting circulating free DNA for the detection of colorectal cancer. Clinical and Translational Medicine (2023).
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