Biomarkers for Early Detection and Monitoring of Colorectal Cancer

Sara K Char; Harshabad Singh; Kimmie Ng

doi:10.1016/j.gtc.2025.10.002

Biomarkers for Early Detection and Monitoring of Colorectal Cancer

Gastroenterol Clin North Am. 2026 Mar;55(1):143-164. doi: 10.1016/j.gtc.2025.10.002. Epub 2025 Nov 27.

Authors

Sara K Char¹, Harshabad Singh², Kimmie Ng²

Affiliations

¹ Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA. Electronic address: sara_char@dfci.harvard.edu.
² Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.

PMID: 41581947
DOI: 10.1016/j.gtc.2025.10.002

Abstract

Colorectal cancer (CRC) is a major global health burden. Although colonoscopy remains the gold standard for screening, less invasive biomarker-based stool and blood tests including FIT, multi-target stool DNA/RNA assays, and blood-based biomarker tests are emerging with promising diagnostic performance. In the post-treatment setting of localized CRC, ctDNA has emerged as a powerful tool, with studies showing it can predict recurrence earlier than imaging or traditional tumor biomarkers. ctDNA testing is used for genomic profiling of CRC to guide therapy decisions. Ongoing research aims to refine ctDNA-based surveillance and integrate it with other biomarkers to transform CRC monitoring and treatment.

Keywords: Colorectal cancer; Early detection; Molecular residual disease; ctDNA.

Publication types

Review

MeSH terms

Biomarkers, Tumor* / blood
Circulating Tumor DNA* / blood
Colorectal Neoplasms* / blood
Colorectal Neoplasms* / diagnosis
Colorectal Neoplasms* / genetics
Early Detection of Cancer* / methods
Feces / chemistry
Humans

Substances

Biomarkers, Tumor
Circulating Tumor DNA