A Review of the Early Detection of Colon Cancer and the Role of Circulating Tumor DNA

Abstract

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer-related deaths when both males and females are considered. Screening plays a crucial role in reducing the incidence and mortality of CRC. Traditionally, CRC screening methods are classified into stool-based and visual-based approaches. Stool-based tests include the guaiac fecal occult blood test, fecal immunochemical test, and multitarget stool DNA test, while visual-based methods encompass colonoscopy, flexible sigmoidoscopy, CT colonography, and capsule endoscopy. Circulating tumor DNA (ctDNA) has emerged as a promising, minimally invasive tool, offering encouraging sensitivity and specificity. However, its high cost remains a limitation. In this review, the authors present a comprehensive overview of current CRC screening tools, with a particular focus on the role of ctDNA.