Biomarkers for Early Detection of Colitis-associated Colorectal Cancer - Current Concepts, Future Trends

Abstract

: Colitis-associated colorectal cancer (CAC) remains a critical complication of ulcerative colitis (UC) with mortality of approximately 15%, which makes early CAC diagnosis crucial. The current standard of surveillance, with repetitive colonoscopies and histological testing of biopsied mucosa samples is burdensome and expensive, and therefore less invasive methods and reliable biomarkers are needed. Significant progress has been made thanks to continuous extensive research in this field, however no clinically relevant biomarker has been established so far. This review of the current literature presents the genetic and molecular differences between CAC and sporadic colorectal cancer and covers progress made in the early detection of CAC carcinogenesis. It focuses on biomarkers under development, which can be easily tested in samples of body fluids or breath and, once made clinically available, will help to differentiate between progressors (UC patients who will develop dysplasia) from non-progressors and enable early intervention to decrease the risk of cancer development.

Root‐cause analyses of missed opportunities for the diagnosis of colorectal cancer in patients with inflammatory bowel disease

“…Accepting that the quality of the evidence is limited, with close concordance to surveillance guidelines, colonoscopic surveillance in IBD reduces the development of CRC and associated mortality through earlier detection and removal of pre‐malignant lesion 22,27,38 . Whilst artificial intelligence and non‐invasive biomarkers of dysplasia are likely to increase the sensitivity of surveillance procedures, these newer techniques have not yet translated to routine clinical care 39 . In the meantime, we have designed a recall system embedded in our electronic record that prompts physicians when surveillance is due, and have completed a case finding survey in primary care.…”

“…22,27,38 Whilst artificial intelligence and non-invasive biomarkers of dysplasia are likely to increase the sensitivity of surveillance procedures, these newer techniques have not yet translated to routine clinical care. 39 In the meantime, we have designed a recall system embedded in our electronic record that prompts physicians when surveillance is due, and have completed a case finding survey in primary care.…”