Predictive and prognostic biomarkers in colorectal cancer: A systematic review of recent advances and challenges.
BACKGROUND
Colorectal cancer (CRC) is one of the leading cause of cancer deaths worldwide. Since CRC is largely asymptomatic until alarm features develop to advanced stages, the implementation of the screening programme is very much essential to reduce cancer incidence and mortality rates. CRC occurs predominantly from accumulation of genetic and epigenetic changes in colon epithelial cells, which later gets transformed into adenocarcinomas.


SCOPE OF REVIEW
The current challenges of screening paradigm and diagnostic ranges are from semi-invasive methods like colonoscopy to non-invasive stool-based test, have resulted in over-diagnosis and over-treatment of CRC. Hence, new screening initiatives and deep studies are required for early diagnosis of CRC. In this regard, we not only summarise current predictive and prognostic biomarkers with their potential for diagnostic and therapeutic applications, but also describe current limitations, future perspectives and challenges associated with the progression of CRC.


MAJOR CONCLUSIONS
Currently many potential biomarkers have already been successfully translated into clinical practice eg. Fecal haemoglobin, Carcinoembryonic antigen (CEA) and CA19.9, although these are not highly promising diagnostic target for personalized medicine. So there is a critical need for reliable, minimally invasive, highly sensitive and specific genetic markers of an individualised and optimised patient treatment at the earliest disease stage possible.


GENERAL SIGNIFICANCE
Identification of a new biomarker, or a set of biomarkers to the development of a valid, and clinical sensible assay that can be served as an alternative tool for early diagnosis of CRC and open up promising new targets in therapeutic intervention strategies.
['Das|Vishal|V|', 'Kalita|Jatin|J|', 'Pal|Mintu|M|']
D000818:Animals D014408:Biomarkers, Tumor D002272:Carcinoembryonic Antigen D003113:Colonoscopy D015179:Colorectal Neoplasms D044127:Epigenesis, Genetic D006801:Humans D011237:Predictive Value of Tests D011379:Prognosis D012307:Risk Factors
Colorectal cancer Challenges and future directions Molecular biomarkers Prevention Screening techniques Signalling pathways