Colorectal Cancer Diagnosis: Colonoscopy, CEA Markers, and TNM Staging

A middle-aged Hispanic physician in a white coat and stethoscope explains the colonoscopy procedure to a Hispanic female patient in her 50s, pointing to an anatomical diagram of the digestive system on a digital screen. The casually dressed patient listens attentively, displaying a slight look of concern. Nearby, medical tools including a colonoscope and labeled vials representing biomarkers are visible. This image emphasizes the significance of colorectal cancer diagnosis, including CEA levels, biopsy, and TNM staging.

Colorectal cancer (CRC) is one of the leading causes of cancer mortality worldwide. Early detection and accurate diagnosis are crucial for improving clinical outcomes and patient survival. In this context, colonoscopy remains the gold standard diagnostic tool, allowing for direct visualization of the colon and biopsy of suspicious lesions. However, the search for less invasive methods has driven the development of biomarkers that can complement or, in some cases, replace colonoscopy in the early detection of CRC.

Colonoscopy is not only essential for diagnosis but also for the prevention of CRC through the detection and removal of premalignant polyps. Despite its effectiveness, its invasive nature may limit participation in screening programs, especially among average-risk populations. In this regard, non-invasive biomarkers have gained attention as complementary tools. These include DNA mutations, methylation, messenger RNA, and microRNA, as well as profiles of gut microbiota and metabolites [1].

The use of liquid biopsies, which analyze biomarkers in body fluids, offers significant advantages in terms of minimal invasiveness and accessibility [2]. Blood-based biomarkers, such as circulating tumor cells and cell-free nucleic acids, are being investigated for their potential in early diagnosis and monitoring of CRC [3]. Additionally, the combination of fecal tests, such as the fecal immunochemical test (FIT), with molecular biomarkers has shown to improve sensitivity and specificity in CRC detection [4].

TNM staging is fundamental for determining prognosis and guiding treatment for CRC. Accurate staging allows for the selection of targeted therapies and assessment of recurrence risk. Advances in biomarker identification have enabled a more personalized approach to CRC treatment, especially in advanced or metastatic cases [5].

In conclusion, the diagnosis of colorectal cancer greatly benefits from a multimodal approach that combines colonoscopy with innovative biomarkers. These advancements not only enhance early detection but also allow for more precise staging and personalized treatment, ultimately improving clinical outcomes and the quality of life for patients.

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Created 6/1/2025