Bai XZ, Bao SCL, Zhang XQ, Yang ZN. Liquid biopsies in colorectal cancer screening and diagnosis. World J Gastrointest Oncol 2026; 18(8): 120332 [DOI: 10.4251/wjgo.120332]
Corresponding Author of This Article
Zhen-Ni Yang, Associate Chief Physician, Department of Gastroenterology and Hepatology, Xing’an League People’s Hospital, No. 66 Hanshan Road, Ulanhot 137400, Inner Mongolia Autonomous Region, China. zhenniyang1107@163.com
Research Domain of This Article
Gastroenterology & Hepatology
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review-article
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Bai XZ, Bao SCL, Zhang XQ, Yang ZN. Liquid biopsies in colorectal cancer screening and diagnosis. World J Gastrointest Oncol 2026; 18(8): 120332 [DOI: 10.4251/wjgo.120332]
World J Gastrointest Oncol. Aug 15, 2026; 18(8): 120332 Published online Aug 15, 2026. doi: 10.4251/wjgo.120332
Liquid biopsies in colorectal cancer screening and diagnosis
Xiao-Zhe Bai, Sa-Chu La Bao, Xu-Qian Zhang, Zhen-Ni Yang
Xiao-Zhe Bai, Department of Gastrointestinal Surgery, Xing’an League People’s Hospital, Ulanhot 137400, Inner Mongolia Autonomous Region, China
Xiao-Zhe Bai, Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
Sa-Chu La Bao, Zhen-Ni Yang, Department of Gastroenterology and Hepatology, Xing’an League People’s Hospital, Ulanhot 137400, Inner Mongolia Autonomous Region, China
Xu-Qian Zhang, Department of Gastroenterology and Hepatology, China Aerospace Science and Industry Corporation 731 Hospital, Beijing 100074, China
Co-first authors: Xiao-Zhe Bai and Sa-Chu La Bao.
Co-corresponding authors: Xu-Qian Zhang and Zhen-Ni Yang.
Author contributions: Yang ZN conceptualized the article and contributed to funding acquisition; Bai XZ and Zhang XQ contributed to the literature search and writing of the original draft; Bao SCL contributed to the manuscript revision; all authors have read and approved the final manuscript; Bai XZ and Bao SCL contributed equally to this manuscript and are co-first authors; Yang ZN and Zhang XQ contributed equally to this manuscript and are co-corresponding authors.
AI contribution statement: I only used ChatGPT for language polishing, expression revision and sentence restructuring. All manuscript content was originally written and independently revised by the authors, with no AI-generated academic content. As a review article, this work does not involve study design, experiments, data analysis or result interpretation, and contains no images. AI was only used for linguistic optimization and did not participate in content creation.
Supported by the Science and Technology Program of the Joint Fund of Scientific Research for the Public Hospitals of Inner Mongolia Academy of Medical Sciences, No. 2023GLLH0449; and the Xing’an League Science and Technology Plan Project, No. MBJH2024001.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Zhen-Ni Yang, Associate Chief Physician, Department of Gastroenterology and Hepatology, Xing’an League People’s Hospital, No. 66 Hanshan Road, Ulanhot 137400, Inner Mongolia Autonomous Region, China. zhenniyang1107@163.com
Received: February 24, 2026 Revised: March 31, 2026 Accepted: June 2, 2026 Published online: August 15, 2026 Processing time: 161 Days and 14.4 Hours
Abstract
Colorectal cancer (CRC) remains a leading cause of global cancer mortality, underscoring the urgent need for effective early detection. Current screening methods, primarily colonoscopy, are limited by invasiveness and low population adherence, while traditional serological biomarkers lack sufficient sensitivity and specificity for reliable early-stage diagnosis. This review examines recent advances in liquid biopsy components as promising noninvasive biomarkers for CRC screening and diagnosis. Key circulating analytes are discussed, including circulating tumor cells, circulating tumor DNA, tumor-educated platelets, exosomes, and circulating RNAs. These markers collectively provide a systemic, real-time molecular profile of tumors, offering valuable information on tumor presence, stage, and biological characteristics beyond that achieved by traditional single-marker approaches. Integrating multiple biomarkers into diagnostic panels shows promise for significantly improving detection accuracy compared to conventional biomarkers like carcinoembryonic antigen. However, translating this potential into clinical practice faces substantial challenges, including the standardization of techniques, validation in large prospective cohorts, and demonstration of improved patient outcomes through interventional studies. Addressing these challenges is essential for realizing the transformative potential of liquid biopsies in personalized CRC management. By enabling earlier, less invasive, and more-accurate diagnosis, liquid biopsy represents a paradigm shift in screening that could ultimately reduce CRC mortality through timely intervention.
Core Tip: Liquid biopsy is revolutionizing colorectal cancer management by enabling noninvasive, real-time tumor profiling through analysis of circulating biomarkers. Emerging evidence supports the clinical utility of multi-analyte panels integrating circulating tumor DNA, circulating tumor cells, tumor-educated platelets, and exosomal RNAs for early detection and molecular characterization, potentially overcoming the limitations of traditional methods and guiding personalized treatment strategies.
