Use of blood-based biomarkers for early diagnosis and surveillance of colorectal cancer

Abstract

Early screening for colorectal cancer (CRC) holds the key to combat and control the increasing global burden of CRC morbidity and mortality. However, the current available screening modalities are severely inadequate because of their high cost and cumbersome preparatory procedures that ultimately lead to a low participation rate. People simply do not like to have colonoscopies. It would be ideal, therefore, to develop an alternative modality based on blood biomarkers as the first line screening test. This will allow for the differentiation of the general population from high risk individuals. Colonoscopy would then become the secondary test, to further screen the high risk segment of the population. This will encourage participation and therefore help to reach the goal of early detection and thereby reduce the anticipated increasing global CRC incidence rate. A blood-based screening test is an appealing alternative as it is non-invasive and poses minimal risk to patients. It is easy to perform, can be repeated at shorter intervals, and therefore would likely lead to a much higher participation rate. This review surveys various blood-based test strategies currently under investigation, discusses the potency of what is available, and assesses how new technology may contribute to future test design.

Analysis and clinical significance of microRNA-499 expression levels in serum of patients with acute myocardial infarction

“…This indicated that microRNAs play an important role in the pathophysiology of disease (Ai et al, 2010). At present, numerous microRNAs have already been found in serum through the application of high-throughput sequencing, and these are widely used in clinical diagnosis and in the determination of prognosis of tumors and other diseases (Ganepola et al, 2014).…”

Development and Clinical Validation of a Blood Test Based on 29-Gene Expression for Early Detection of Colorectal Cancer

“…There is therefore an unmet need for an effective and routine test for asymptomatic average-risk individuals. A blood-based test is highly attractive due to its minimal invasiveness, convenience, and high acceptance by individuals at average risk (9)(10)(11).…”

Biomarkers in Colorectal Cancer Screening

“…NGS is not only fast and cheaper but it also enables researchers to perform direct RNA sequencing (RNA-seq) to sequence the whole transcriptome (ie, the entire set of coding and noncoding RNAs). 44 mRNA Markers: In a proof-of-concept study, Tsouma et al 45 demonstrated that extracted carcinoembryonic antigen (CEA), cytokeratin 20, and epidermal growth factor receptor (EGFR) transcripts from patients with CRC can indicate disease stage and prognosis.…”

“…48 miR-17-3p, miR-92, miR-92a, miR-29a, miR-141, and miR-21 have been associated with advanced CRC and poor prognosis. 44,49 miR-21 expression levels may be a special pan-cancer marker, because it has been shown to be upregulated in other cancers. 50 miR-15b, miR-17-3p, miR-18a, miR-20a, miR-21, miR-29a, and miR-92a have been studied by multiple investigators for CRC detection.…”

“…Other DNA Markers: Other circulating tumorrelated molecules, such as aberrant DNA markers, microsatellite alterations markers, and mitochondrial DNA, are currently very difficult to detect against the background of all other circulating DNA, 44 especially in early-stage CRC, making them unsuitable as screening biomarkers.…”