Progress in the field of noninvasive diagnostics for colorectal cancer: a systematic review for the accuracy of blood-based biomarkers for detection of advanced pre-cancerous lesions

Rishabh Goyal, Molla M. Wassie, Jean M. Winter, Timothy J. H. Lathlean, Graeme P. Young, Erin L. Symonds

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)

Abstract

Background: Early detection of pre-cancerous adenomas through screening can reduce colorectal cancer (CRC) incidence. Fecal immunochemical tests are commonly used, but have limited sensitivity for pre-cancerous lesions. Blood-based screening may improve test sensitivity. This systematic review and meta-analysis was conducted to evaluate the accuracy of blood-based biomarkers for detection of advanced pre-cancerous lesions. 

Research design and methods: We present the accuracy of blood-based biomarkers for the detection of advanced pre-cancerous lesions. EMBASE, Web of Science and PubMed databases were searched, with study populations limited to adults diagnosed with advanced pre-cancerous lesions at colonoscopy, who had a blood-based biomarker test analyzed with reports of sensitivity and specificity. 

Results: 69 studies were identified, which assessed 133 unique biomarkers sets. The best performing test was a panel of 6 miRNAs, with a sensitivity of 95% and specificity of 90% for advanced pre-cancerous lesions. Only 6 biomarkers demonstrated sensitivity ≥ 50% and specificity ≥ 90% for the detection of advanced pre-cancerous lesions. 

Conclusion: Many different blood-based biomarkers have been assessed for detection of advanced pre-cancerous lesions, but few have progressed beyond the discovery stage. While some biomarkers have reported high sensitivity and specificity, larger prospective studies in unbiased intended-use screening populations are required for validation.

Original languageEnglish
Pages (from-to)1233-1250
Number of pages18
JournalExpert Review of Molecular Diagnostics
Volume23
Issue number12
Early online date15 Dec 2023
DOIs
Publication statusPublished - 2023

Keywords

  • advanced adenoma
  • Blood biomarker
  • colorectal cancer
  • ctDNA
  • early detection
  • prevention
  • screening
  • sensitivity

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