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Screening for colorectal cancer leading into a new decade: the “Roaring ‘20s” for epigenetic biomarkers?

dc.contributor.authorAlmeida-Lousada, Hélder
dc.contributor.authorMestre, André
dc.contributor.authorRamalhete, Sara Maria Ventura
dc.contributor.authorPrice, Aryeh J.
dc.contributor.authorDe Mello, Ramon Andrade
dc.contributor.authorMarreiros, Ana
dc.contributor.authorNeves, Ricardo Pires das
dc.contributor.authorCastelo-Branco, Pedro
dc.date.accessioned2022-01-06T15:02:06Z
dc.date.available2022-01-06T15:02:06Z
dc.date.issued2021-11-20
dc.date.updated2021-12-23T15:06:31Z
dc.description.abstractColorectal cancer (CRC) has an important bearing (top five) on cancer incidence and mortality in the world. The etiology of sporadic CRC is related to the accumulation of genetic and epigenetic alterations that result in the appearance of cancer hallmarks such as abnormal proliferation, evasion of immune destruction, resistance to apoptosis, replicative immortality, and others, contributing to cancer promotion, invasion, and metastasis. It is estimated that, each year, at least four million people are diagnosed with CRC in the world. Depending on CRC staging at diagnosis, many of these patients die, as CRC is in the top four causes of cancer death in the world. New and improved screening tests for CRC are needed to detect the disease at an early stage and adopt patient management strategies to decrease the death toll. The three pillars of CRC screening are endoscopy, radiological imaging, and molecular assays. Endoscopic procedures comprise traditional colonoscopy, and more recently, capsule-based endoscopy. The main imaging modality remains Computed Tomography (CT) of the colon. Molecular approaches continue to grow in the diversity of biomarkers and the sophistication of the technologies deployed to detect them. What started with simple fecal occult blood tests has expanded to an armamentarium, including mutation detection and identification of aberrant epigenetic signatures known to be oncogenic. Biomarker-based screening methods have critical advantages and are likely to eclipse the classical modalities of imaging and endoscopy in the future. For example, imaging methods are costly and require highly specialized medical personnel. In the case of endoscopy, their invasiveness limits compliance from large swaths of the population, especially those with average CRC risk. Beyond mere discomfort and fear, there are legitimate iatrogenic concerns associated with endoscopy. The risks of perforation and infection make endoscopy best suited for a confirmatory role in cases where there are positive results from other diagnostic tests. Biomarker-based screening methods are largely non-invasive and are growing in scope. Epigenetic biomarkers, in particular, can be detected in feces and blood, are less invasive to the average-risk patient, detect early-stage CRC, and have a demonstrably superior patient follow-up. Given the heterogeneity of CRC as it evolves, optimal screening may require a battery of blood and stool tests, where each can leverage different pathways perturbed during carcinogenesis. What follows is a comprehensive, systematic review of the literature pertaining to the screening and diagnostic protocols used in CRC. Relevant articles were retrieved from the PubMed database using keywords including: “Screening”, “Diagnosis”, and “Biomarkers for CRC”. American and European clinical trials in progress were included as well.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifierdoi: 10.3390/curroncol28060411
dc.identifier.citationCurrent Oncology 28 (6): 4874-4893 (2021)pt_PT
dc.identifier.doi10.3390/curroncol28060411pt_PT
dc.identifier.issn1718-7729
dc.identifier.urihttp://hdl.handle.net/10400.1/17442
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMDPIpt_PT
dc.relationCenter for Innovative Biomedicine and Biotechnology
dc.relationCenter for Innovative Biomedicine and Biotechnology
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectColorectal cancerpt_PT
dc.subjectEpigenetic testingpt_PT
dc.subjectScreeningpt_PT
dc.subjectDiagnosispt_PT
dc.subjectCRC biomarkerspt_PT
dc.titleScreening for colorectal cancer leading into a new decade: the “Roaring ‘20s” for epigenetic biomarkers?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleCenter for Innovative Biomedicine and Biotechnology
oaire.awardTitleCenter for Innovative Biomedicine and Biotechnology
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDB%2F04539%2F2020/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDP%2F04539%2F2020/PT
oaire.citation.endPage4893pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage4874pt_PT
oaire.citation.titleCurrent Oncologypt_PT
oaire.citation.volume28pt_PT
oaire.fundingStream6817 - DCRRNI ID
oaire.fundingStream6817 - DCRRNI ID
person.familyNameMestre
person.familyNameVentura Ramalhete
person.familyNamede Mello
person.familyNameMarreiros
person.familyNameCastelo-Branco
person.givenNameAndré
person.givenNameSara Maria
person.givenNameRamon Andrade
person.givenNameAna
person.givenNamePedro
person.identifier1921495
person.identifier.ciencia-idC113-BBFB-4848
person.identifier.ciencia-id9A12-9450-7051
person.identifier.ciencia-idE015-7F8F-5CA1
person.identifier.orcid0000-0001-6930-5409
person.identifier.orcid0000-0001-8236-2432
person.identifier.orcid0000-0002-9640-4573
person.identifier.orcid0000-0001-9410-4772
person.identifier.orcid0000-0002-3453-3978
person.identifier.scopus-author-id57194785077
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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