Colorectal cancer (CRC) is rising worldwide, particularly early-onset cases, creating an urgent need for earlier detection to improve survival. Traditional screening methods have limitations: colonoscopy is invasive and resource-intensive, while stool-based tests like FIT often miss early-stage cancers.
CRC arises from adenomas through cumulative mutations (e.g., APC, KRAS, TP53) and exhibits molecular heterogeneity, classified into four Consensus Molecular Subtypes (CMS). Early-onset CRC is linked to birth cohort effects, obesity, and Western diets, prompting recommendations to begin screening at age 45.
Emerging diagnostics are focusing on liquid biopsies that capture non-tumor signals—metabolic, immune, and gut microbiome changes during precancerous states. Cutting-edge approaches include high-throughput proteomics (Olink, SomaScan) and multi-omic spectral analysis (infrared spectroscopy), aiming to provide sensitive, non-invasive, and cost-effective detection. These tools could revolutionize early CRC screening and overcome the limitations of current methods.