Early Detection Of Colorectal Cancer Research Articles

Screening for Colorectal Cancer: The Role of Clinical Laboratories.

Colorectal cancer (CRC) is a leading cause of cancer incidence and mortality. Screening can result in reductions in incidence and mortality, but there are many challenges to uptake and follow-up. Here, we will review the changing epidemiology of CRC, including increasing trends for early and later onset CRC; evidence to support current and emerging screening strategies, including noninvasive stool and blood-based tests; key challenges to ensuring uptake and high-quality screening; and the critical role that clinical laboratories can have in supporting health system and public health efforts to reduce the burden of CRC on the population. Clinical laboratories have the opportunity to play a seminal role in optimizing early detection and prevention of CRC.

Early colorectal cancer detection: a serum analysis platform combining SERS and machine learning.

Colorectal cancer (CRC) is one of the deadliest malignancies globally, with high incidence and mortality rates. Early detection is crucial for improving treatment success rates and patient survival. However, due to the difficulty in detecting early symptoms, many cases are diagnosed at advanced stages, necessitating more sensitive and accurate detection methods. This study proposes a novel approach combining the Principal Component Analysis (PCA)-Dynamic Weighted Nearest Neighbor (DWNN) model with Surface-Enhanced Raman Scattering (SERS) technology to detect the serum of CRC mice at different stages. Establishing the CRC mice model, serum samples were collected for further analysis. An Au Nanocluster (AuNC) substrate was synthesized to ensure optimal SERS enhancement. The PCA-DWNN recognition model was constructed to classify the SERS spectra of CRC at different stages. The synthesized AuNC substrate has high sensitivity, good reproducibility, uniformity, and stability, making it a high-performance nanomaterial. The PCA-DWNN model has significant advantages in identifying high-dimensional and complex SERS spectra, offering excellent classification accuracy and robustness, with an accuracy rate of 97.5%. By analyzing the PCA loading plot, it was observed that as CRC progressed, the content and structure of proteins, lipids, amino acids, and carbohydrates in the serum changed, reflected in different characteristic peaks in the SERS spectra. This study suggests that SERS combined with PCA-DWNN has potential in the early detection of CRC, possibly providing a novel approach for clinical diagnostics.

Trans-ancestry analysis in over 799,000 individuals yields new insights into the genetic etiology of colorectal cancer.

Recent studies have demonstrated the relevance of circulating factors in the occurrence and development of colorectal cancer (CRC); however, the causal relationship remains unclear. Summary-level data for CRC were obtained from the UK Biobank (5,657 cases and 372,016 controls), FinnGen cohort (3,022 cases and 215,770 controls), and BioBank Japan Project (BBJ, 7,062 cases and 195,745 controls). Thirty-two peripheral markers with consistent definitions were collected from the three biobanks. Mendelian randomization (MR) was used to evaluate the causal effect of circulating factors on CRC. The effects from the three consortiums were combined using trans-ancestry meta-analysis methods. Our analysis provided compelling evidence for the causal association of higher genetically predicted eosinophil cell count (EOS, odds ratio [OR], 0.8639; 95% confidence interval [CI] 0.7922-0.9421) and red cell distribution width (RDW, OR, 0.9981; 95% CI, 0.9972-0.9989) levels with a decreased risk of CRC. Additionally, we found suggestive evidence indicating that higher levels of total cholesterol (TC, OR, 1.0022; 95% CI, 1.0002-1.0042) may increase the risk of CRC. Conversely, higher levels of platelet count (PLT, OR, 0.9984; 95% CI, 0.9972-0.9996), total protein (TP, OR, 0.9445; 95% CI, 0.9037-0.9872), and C-reactive protein (CRP, OR, 0.9991; 95% CI, 0.9983-0.9999) may confer a protective effect against CRC. Moreover, we identified six ancestry-specific causal factors, indicating the necessity of considering patients' ancestry backgrounds before formulating prevention strategies. MR findings support the independent causal roles of circulating factors in CRC, which might provide a deeper insight into early detection of CRC and supply potential preventative strategies.

The mechanisms and drug therapies of colorectal cancer and epigenetics: bibliometrics and visualized analysis.

Numerous studies have demonstrated a link between epigenetics and CRC. However, there has been no systematic analysis or visualization of relevant publications using bibliometrics. 839 publications obtained from the Web of Science Core (WoSCC) were systematically analyzed using CiteSpace and VOSviewer software. The results show that the countries, institutions, and authors with the most published articles are the United States, Harvard University, and Ogino and Shuji, respectively. SEPT9 is a blood test for the early detection of colorectal cancer. Vitamin D and gut microbiota mediate colorectal cancer and epigenetics, and probiotics may reduce colorectal cancer-related symptoms. We summarize the specific epigenetic mechanisms of CRC and the current existence and potential epigenetic drugs associated with these mechanisms. It is closely integrated with clinical practice, and the possible research directions and challenges in the future are proposed. This study reviews the current research trends and hotspots in CRC and epigenetics, which can promote the development of this field and provide references for researchers in this field.

Advances in blood DNA methylation-based assay for colorectal cancer early detection: a systematic updated review.

A systematic review was conducted to summarize the methylated circulating tumor DNA (ctDNA) markers reported over the last decade for early detection of colorectal cancer (CRC) and to identify the main technical challenges that are impeding their clinical implementation. CRC is a major cause of cancer deaths worldwide, but early detection is key for successful treatment. Non-invasive methods such as methylated ctDNA testing show promise for improving detection and monitoring of CRC. A comprehensive search was performed using Web of Science, PubMed, and Scopus up to December 30, 2023, limited to articles published in the last 10 years (after 2012), while including advanced adenoma/stage 0 or stage I/II samples in biomarker validation. After identifying 694 articles, removing duplicates and screening titles, abstracts, and full texts, a total of 62 articles were found to meet the inclusion criteria. Among the single biomarkers, MYO1-G, SEPT9, SDC2, and JAM3 revealed the highest sensitivity for polyps and stage I/II CRC. For multi-biomarkers with suitable sensitivity, combinations of SFRP1, SFRP2, SDC2, PRIMA1, or ALX4, BMP3, NPTX2, RARB, SDC2, SEPT9, VIM or ZFHX4, ZNF334, ELOVL2, UNC5C, LOC146880, SFMBT2, GFRA1 were identified for polyps and stage I/II CRC. Enhancing sensitivity and specificity of molecular screening methods is crucial for improving CRC detection. Identifying a select few valuable biomarkers is key to reducing costs, despite challenges posed by low ctDNA levels in plasma, particularly in early-stage cancers.

Fano Enhancement of SERS for Rapid Early Diagnosis of Colorectal Cancer

Patients benefit greatly from early detection of colorectal cancer, but present diagnostic procedures have high costs, low sensitivity, and low specificity. However, it is still difficult to develop a strategy...

Design and Analysis of High-Performance Optical Fiber-Based Surface Plasmon Resonance Sensor for Early Detection of Colorectal Cancer

Design and Analysis of High-Performance Optical Fiber-Based Surface Plasmon Resonance Sensor for Early Detection of Colorectal Cancer

Cell-free DNA methylation profiles enable early detection of colorectal and gastric cancer

Cell-free DNA methylation profiles enable early detection of colorectal and gastric cancer

Abnormal Colorectal Cancer Test Follow-Up: A Quality Improvement Initiative at a Federally Qualified Health Center.

Colonoscopy completion rates after an abnormal fecal immunochemical test (FIT) are suboptimal, resulting in missed opportunities for early detection and prevention of colorectal cancer. Patient navigation and structured follow-up may improve colonoscopy completion, but implementation of these strategies is not widespread. We conducted a quality improvement study using a Plan-Do-Study-Act (PDSA) Model to increase colonoscopy completion after abnormal FIT in a large federally qualified health center serving a diverse and low-income population. Intervention components included patient navigation, and a checklist to promote completion of key steps required for abnormal FIT follow-up. Primary outcome was proportion of patients achieving colonoscopy completion within 6 months of abnormal FIT, assessed at baseline for 156 patients pre-intervention, and compared to 208 patients during the intervention period from April 2017 to December 2019. Drop offs at each step in the follow-up process were assessed. Colonoscopy completion improved from 21% among 156 patients with abnormal FIT pre-intervention, to 38% among 208 patients with abnormal FIT during the intervention (P < .001; absolute increase: 17%, 95% CI: 6.9%-25.2%). Among the 130 non-completers during the intervention period, lack of completion was attributable to absence of colonoscopy referral for 7.7%; inability to schedule a pre-colonoscopy specialist visit for 71.5%; failure to complete a pre-colonoscopy visit for 2.3%; the absence of colonoscopy scheduling for 9.2%; failure to show for a scheduled colonoscopy for 9.2%. Patient navigation and structured follow-up appear to improve colonoscopy completion after abnormal FIT. Additional strategies are needed to achieve optimal rates of completion.

Current Research on Molecular Biomarkers for Colorectal Cancer in Stool Samples.

Colorectal cancer (CRC) is one of the most diagnosed cancers worldwide, with a high incidence and mortality rate when diagnosed late. Currently, the methods used in healthcare to diagnose CRC are the fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. However, the lack of sensitivity and specificity and low population adherence are driving the need to implement other technologies that can identify biomarkers that not only help with early CRC detection but allow for the selection of more personalized treatment options. In this regard, the implementation of omics technologies, which can screen large pools of biological molecules, coupled with molecular validation, stands out as a promising tool for the discovery of new biomarkers from biopsied tissues or body fluids. This review delves into the current state of the art in the identification of novel CRC biomarkers that can distinguish cancerous tissue, specifically from fecal samples, as this could be the least invasive approach.

The DNA methylation of the interleukin6 as a biomarker for the early detection of colorectal cancer

Objectives: To identify the DNA methylation pattern of the interleukin6 promoter region in colorectal cancer patients and colorectal polys patients that could be a biomarker for early detection of colorectal cancer.&#x0D; Methods: For this purpose, we examined the DNA methylation pattern of the promoter region of the IL6 specifically 358 bp (-292 to +67) including 7 CpG sites (-228, -213, -163, -119, +10, +19, +25) in a total of ninety samples with thirty samples each for controls, cancer patients, and colorectal polyps using the bisulfite conversion sequencing method.&#x0D; Result: Our results indicate that CpG +25 and CpG -119 can serve as biomarkers for early detection of colon cancer, showing a significant difference in P-values of 0.001 at CpG +25 and 0.004 at CpG-119. The hypomethylation of CpG -119 in cancer groups facilitates the binding of the methyl-sensitive transcription factor Sp1. It enhances the overexpression of IL6 besides hypermethylation of CpG +25 that prevents binding of the methyl-sensitive insulator CTF, unbinding the insulator to the promoter region of the cancer samples makes the promoter region open access to the TFs that enhances overexpression. Furthermore, a remarkable non-recorded SNP at CpG -228 was observed in 98.6% of the enrolled groups.&#x0D; Conclusion: In the state of DNA methylation, IL 6 could contribute to the onset of colorectal polyps and colorectal polyps cancer due to a significant level of methylation in CpG +25 and CpG -119.

Determination of dimethylated nucleosides in serum from colorectal cancer patients by hydrophilic interaction liquid chromatography-tandem mass spectrometry

RNA modifications play a crucial regulatory role in a variety of biological processes and are closely related to numerous diseases, including cancer. The diversity of metabolites in serum makes it a favored biofluid for biomarkers discovery. In this work, a robust and accurate hydrophilic interaction liquid chromatography-tandem mass spectrometry (HILIC-MS/MS) approach was established for simultaneous determination of dimethylated nucleosides in human serum. Using the established method, we were able to accurately quantify the concentrations of N6-2′-O-dimethyladenosine (m6Am), N2,N2-dimethylguanosine (m2,2G), and 5,2′-O-dimethyluridine (m5Um) in serum samples from 53 healthy controls, 57 advanced colorectal adenoma patients, and 39 colorectal cancer (CRC) patients. The results showed that, compared with healthy controls and advanced colorectal adenoma patients, the concentrations of m6Am and m2,2G were increased in CRC patients, while the concentration of m5Um was decreased in CRC patients. These results indicate that these three dimethylated nucleosides could be potential biomarkers for early detection of colorectal cancer. Interestingly, the level of m5Um was gradually decreased from healthy controls to advanced colorectal adenoma patients to CRC patients, indicating m5Um could also be used to evaluate the level of malignancy of colorectal tumor. In addition, this study will contribute to the investigation on the regulatory mechanisms of RNA dimethylation in the onset and development of colorectal cancer.

Development of fecal microbial diagnostic marker sets of colorectal cancer using natural language processing method.

Cancer screening and early detection greatly increase the chances of successful treatment. However, most cancer types lack effective early screening biomarkers. In recent years, natural language processing (NLP)-based text-mining methods have proven effective in searching the scientific literature and identifying promising associations between potential biomarkers and disease, but unfortunately few are widely used. In this study, we used an NLP-enabled text-mining system, MarkerGenie, to identify potential stool bacterial markers for early detection and screening of colorectal cancer. After filtering markers based on text-mining results, we validated bacterial markers using multiplex digital droplet polymerase chain reaction (ddPCR). Classifiers were built based on ddPCR results, and sensitivity, specificity, and area under the curve (AUC) were used to evaluate the performance. A total of 7 of the 14 bacterial markers showed significantly increased abundance in the stools of colorectal cancer patients. A five-bacteria classifier for colorectal cancer diagnosis was built, and achieved an AUC of 0.852, with a sensitivity of 0.692 and specificity of 0.935. When combined with the fecal immunochemical test (FIT), our classifier achieved an AUC of 0.959 and increased the sensitivity of FIT (0.929 vs. 0.872) at a specificity of 0.900. Our study provides a valuable case example of the use of NLP-based marker mining for biomarker identification.

Advancing Colorectal Cancer Diagnosis with AI-Powered Breathomics: Navigating Challenges and Future Directions.

Early detection of colorectal cancer is crucial for improving outcomes and reducing mortality. While there is strong evidence of effectiveness, currently adopted screening methods present several shortcomings which negatively impact the detection of early stage carcinogenesis, including low uptake due to patient discomfort. As a result, developing novel, non-invasive alternatives is an important research priority. Recent advancements in the field of breathomics, the study of breath composition and analysis, have paved the way for new avenues for non-invasive cancer detection and effective monitoring. Harnessing the utility of Volatile Organic Compounds in exhaled breath, breathomics has the potential to disrupt colorectal cancer screening practices. Our goal is to outline key research efforts in this area focusing on machine learning methods used for the analysis of breathomics data, highlight challenges involved in artificial intelligence application in this context, and suggest possible future directions which are currently considered within the framework of the European project ONCOSCREEN.

Identification of Differentially Expressed Genes in Human Colorectal Cancer Using RNASeq Data Validated on the Molecular Level with Real-Time PCR

Colorectal cancer (CRC) is a prevalent cancer with high morbidity and mortality rates worldwide. Late diagnosis is a significant contributor to low survival rates in a minority of cases. The study aimed to perform a robust pipeline using integrated bioinformatics tools that will enable us to identify potential diagnostic and prognostic biomarkers for early detection of CRC by exploring differentially expressed genes (DEGs). In addition to, testing the capability of replacing chemotherapy with plant extract in CRC treatment by validating it using real-time PCR. RNA-seq data from cancerous and adjacent normal tissues were pre-processed and analyzed using various tools such as FastQC, Kallisto, DESeq@ R package, g:Profiler, GNEMANIA-CytoScape and CytoHubba, resulting in the identification of 1641 DEGs enriched in various signaling routes. MMP7, TCF21, and VEGFD were found to be promising diagnostic biomarkers for CRC. An in vitro experiment was conducted to examine the potential anticancer properties of 5-fluorouracile, Withania somnifera extract, and their combination. The extract was found to exhibit a positive trend in gene expression and potential therapeutic value by targeting the three genes; however, further trials are required to regulate the methylation promoter. Molecular docking tests supported the findings by revealing a stable ligand-receptor complex. In conclusion, the study’s analysis workflow is precise and robust in identifying DEGs in CRC that may serve as biomarkers for diagnosis and treatment. Additionally, the identified DEGs can be used in future research with larger sample sizes to analyze CRC survival.

Analyzing aberrant DNA methylation in colorectal cancer uncovered intangible heterogeneity of gene effects in the survival time of patients

Colorectal cancer (CRC) involves epigenetic alterations. Irregular gene-methylation alteration causes and advances CRC tumor growth. Detecting differentially methylated genes (DMGs) in CRC and patient survival time paves the way to early cancer detection and prognosis. However, CRC data including survival times are heterogeneous. Almost all studies tend to ignore the heterogeneity of DMG effects on survival. To this end, we utilized a sparse estimation method in the finite mixture of accelerated failure time (AFT) regression models to capture such heterogeneity. We analyzed a dataset of CRC and normal colon tissues and identified 3406 DMGs. Analysis of overlapped DMGs with several Gene Expression Omnibus datasets led to 917 hypo- and 654 hyper-methylated DMGs. CRC pathways were revealed via gene ontology enrichment. Hub genes were selected based on Protein–Protein-Interaction network including SEMA7A, GATA4, LHX2, SOST, and CTLA4, regulating the Wnt signaling pathway. The relationship between identified DMGs/hub genes and patient survival time uncovered a two-component mixture of AFT regression model. The genes NMNAT2, ZFP42, NPAS2, MYLK3, NUDT13, KIRREL3, and FKBP6 and hub genes SOST, NFATC1, and TLE4 were associated with survival time in the most aggressive form of the disease that can serve as potential diagnostic targets for early CRC detection.

A deep learning approach for the detection and counting of colon cancer cells (HT-29 cells) bunches and impurities.

HT-29 has an epithelial appearance as a human colorectal cancer cell line. Early detection of colorectal cancer can enhance survival rates. This study aims to detect and count HT-29 cells using a deep-learning approach (ResNet-50). The cell lines were procured from Procell Life Science & Technology Co., Ltd. (Wuhan, China). Further, the dataset is self-prepared in lab experiments, cell culture, and collected 566 images. These images contain two classes; the HT-29 human colorectal adenocarcinoma cells (blue shapes in bunches) and impurities (tinny circular grey shapes). These images are annotated with the help of an image labeller as impurity and cancer cells. Then afterwards, the images are trained, validated, and tested against the deep learning approach ResNet50. Finally, in each image, the number of impurity and cancer cells are counted to find the accuracy of the proposed model. Accuracy and computational expense are used to gauge the network's performance. Each model is tested ten times with a non-overlapping train and random test splits. The effect of data pre-processing is also examined and shown in several tasks. The results show an accuracy of 95.5% during training and 95.3% in validation for detecting and counting HT-29 cells. HT-29 cell detection and counting using deep learning is novel due to the scarcity of research in this area, the application of deep learning, and potential performance improvements over traditional methods. By addressing a gap in the literature, employing a unique dataset, and using custom model architecture, this approach contributes to advancing colon cancer understanding and diagnosis techniques.

Abstract A100: Racial disparities in the relationship of regional socioeconomic status and colorectal cancer survival in the five regions of Georgia

Abstract Background: Significantly higher colorectal cancer (CRC) mortality exists in the five public health districts of Georgia including the Clayton, West Central, East Central, Southeast, and Northeast Georgia. Particularly, CRC outcomes are poorer among patients living in low socioeconomic (SES) areas with predominantly Black population in Georgia. We sought to examine 5-year CRC survival rates between White and Black/Other patients and determine whether regional SES status associated with 5-year CRC survival within different race groups in these five regions of Georgia. Methods: We performed a retrospective cohort analysis using data from the 1975-2016 Surveillance, Epidemiology, and End Results program. The 2015 United State Department of Agriculture Economic Research Services (USDA ERS) county typology codes were used to identify region-level SES with persistent poverty, low employment, and low education. A county is classified by the USDA ERS as a persistent poverty by using 1980, 1990, 2000 censuses and 2007-11 American Community Survey. Five-year CRC survival rates were compared by using Kaplan-Meier method. Cox proportional hazard regression was used to examine the aforementioned associations in different race groups adjusted for demographics (gender, age at diagnosis, marital status, and five Georgia regions) and tumor features (stage, grade, and primary site). Results: Among 11,023 CRC patients (31.9% Black/Other patients), 5-year CRC survival rates were lower among Black/Other patients compared to White patients (65.9% vs. 69.9%; p-value&amp;lt;0.001). Black/Other patients living in low education, low employment, and persistent poverty regions appeared to have lower 5-year survival rates compared to those not living in those regions (59.6% vs. 67.8%, p-value&amp;lt;0.001; 65.4% vs. 66.2%, p-value=0.385; 64.4% vs. 66.5%, p-value=0.089 respectively). In the adjusted analysis, we found that White patients living in regions with persistent poverty were 1.12-fold of increased risk of CRC death (HR, 1.12; 95% CI, 1.00-1.25; p-value=0.043) compared to those living in non-persistent poverty regions. Among Black/Other patients, those living in regions with low education were 1.19-fold of increased risk of CRC death (HR, 1.19; 95% CI, 1.01-1.40; p-value=0.033) compared to those living in non-low education regions. Other factors, such as older age at diagnosis, distant stage, and high-grade tumors, were positively associated with CRC death among the entire cohort, regardless of racial groups. Conclusion: In Georgia, we found that Black/Other patients demonstrated the lower CRC survival rates. Region-level SES was associated with CRC survival among White and Black/Other patients. White patients living in regions with persistent poverty, and Black/Other patients living in regions with low education had an increased risk of CRC death. Our findings provide important evidence to relevant stakeholders in furthering the development of culturally tailored CRC screening interventions aimed at CRC early detection by considering patient’s regional SES status in Georgia. Citation Format: Meng-Han Tsai, Shaoyong Su, Marlo Vernon, Yanbin Dong. Racial disparities in the relationship of regional socioeconomic status and colorectal cancer survival in the five regions of Georgia [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A100.

Abstract B148: Colorectal cancer screening uptake and test use for individuals with diabetes in the U.S.: Implications for health equity

Abstract Purpose: Individuals with diabetes mellitus have an estimated 27% elevated risk of developing colorectal cancer (CRC) and are disproportionately from health disparities populations. This study examined associations of race and ethnicity and CRC screening uptake and CRC test type used among individuals with diabetes to identify factors to consider in targeting CRC screening efforts to promote health equity. Methods: Merged Medical Expenditures Panel Survey Household Component (2012-2018) and National Health Interview Survey data sets were used to identify individuals with diabetes (non-Hispanic White (NHW) n=223,046; Hispanic n=54,791; Non-Hispanic Black (NHB) n=54,791). The main outcomes were self-reported up-to-date CRC screening based on United States Preventive Services Taskforce guidelines and screening test used (i.e., blood-stool test or direct visualization). The main independent variable of interest was race and ethnicity. Logistic regression models included socio-demographic and health-related co-variates. Results: Among individuals with diabetes 62.6% reported being up-to-date (UTD) with CRC screening, among the screened 5.8% used blood stool tests only and 56.8% used direct visualization tests. In the final logistic model comparing relative risk of UTD screening to being unscreened, NHBs were more likely to be UTD for CRC screening [RR: 1.3, 95% CI: 1.13-1.53, p=0.001] compared to NHWs. Individuals with no high school degree [RR: 0.8, 95% CI: 0.65-0.99, p=0.3] were less likely to be UTD compared to college educated individuals. Individuals receiving recommended diabetes care were less likely to be unscreened [RR: 0.84, 95% CI: 0.76-0.94, p=0.002]. Among screened individuals, race and ethnicity were insignificant in final models. Low-income individuals were less likely to be screened with direct visualization [RR: 0.73, 95% CI: 0.55-0.97, p=0.03] compared to high-income individuals. Overweight individuals (BMI 26-29) were less likely to be screened with direct visualization [RR:0.75, 95% CI:0.57-0.99, p=0.41] compared to individuals with BMI ≤25. Individuals with five or more comorbidities were more likely to be screened using direct visualization [RR: 3.45, 95% CI: 1.86, 6.43, p&amp;lt;0.001] compared to individuals with 1-2 comorbidities. Conclusions: Among individuals with diabetes, social determinants and health factors associated with UTD and testing type differed. Race, education, and diabetes care quality were determinants of receipt of any UTD CRC testing. Among those screened, lower income and overweight individuals were more likely to use stool-based testing and those with greater comorbidity burdens were more likely to be screened with direct visualization. Efforts to improve CRC screening for patients with diabetes, specifically those in the primary care safety-net, should consider these factors when tailoring CRC prevention and early detection efforts. Citation Format: Denalee M. O'Malley, Pamela Ohman-Strickland, Tracy Andrews, Cilgy Abraham, Benjamin F. Crabtree, Shawna V. Hudson, Anita Y. Kinney. Colorectal cancer screening uptake and test use for individuals with diabetes in the U.S.: Implications for health equity [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B148.

Developing a Novel Non-invasive Serum-based Diagnostic Test for Early Detection of Colorectal Cancer

Abstract Introduction/Objective Colorectal cancer (CRC) is the third-most common cancer worldwide, and early detection is vital for successful treatment and improved outcomes. Current screening methods such as colonoscopy, fecal occult blood tests, and stool DNA tests have limitations such as patient discomfort, cost, and low sensitivity and specificity most commonly diagnosed cancer worldwide with a high mortality rate. Early detection remains a crucial factor in reducing the burden of CRC. Currently, the gold standard for CRC diagnosis is colonoscopy, but it may not be feasible for widespread screening due to its invasiveness, cost, and patient compliance issues. Therefore, there is a great need to identify reliable biomarkers that can detect CRC at an early stage. This study aimed to evaluate the effectiveness of updated novel biomarkers for early detection of CRC. Methods/Case Report This study was conducted on 158 patients with suspected or confirmed CRC. The study population included patients of both genders, aged above 18 years, and with a history of CRC or other relevant risk factors. Blood samples were collected from all included patients, and the biomarkers (CTCS, miRNAs, ctDNA, and Methylated DNA markers ) were measured using enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) tests. Novel biomarkers compared their diagnostic performance with existing biomarkers such as fecal occult blood tests (FOBTs), fecal immunochemical tests (FITs), and CEA. Results (if a Case Study enter NA) The studied biomarkers (CTCs, microRNAs, ctDNA, and Methylated DNA markers) have high sensitivity from 78.8 % to 96.72% and accuracy from 83.76% to 94.83% as well as their cut-off which approved the objective of this study. Overall, these novel biomarkers show promise for early detection of colorectal cancer and may improve screening and early detection efforts. Conclusion The evaluation of the studied biomarkers (Circulating Tumor Cells, microRNAs, Circulating tumor DNA, and Methylated DNA markers) for early detection of CRC has substantial clinical and public health implications. The identification of reliable biomarkers for CRC screening can avoid unnecessary colonoscopies, reduce the burden on healthcare costs, and improve the detection of early-stage CRC.