Researchers are shifting toward blood-based biomarker tests to detect colorectal adenomas (CRAs), which are precancerous lesions that can lead to colorectal cancer. While colonoscopy and stool tests (FIT) are standard, blood tests are more convenient and may better detect non-bleeding lesions, improving patient compliance.
Key approaches include noncoding RNAs (such as microRNAs and circular RNAs), DNA methylation markers like SEPT9, and newer multigene assays that improve detection of advanced adenomas. Studies in proteomics and metabolomics also show that protein and metabolic changes in blood can help distinguish healthy individuals from those with adenomas or cancer.
Although colonoscopy remains the gold standard, blood-based testing is promising. However, it still has limited sensitivity for small adenomas. Future strategies will likely combine multiple biomarkers—RNA, DNA, and proteins—possibly using AI, to create a more accurate and widely accepted screening tool.