Published online Oct 15, 2015. doi: 10.4251/wjgo.v7.i10.178
Peer-review started: May 7, 2015
First decision: June 2, 2015
Revised: June 17, 2015
Accepted: August 25, 2015
Article in press: August 28, 2015
Published online: October 15, 2015
Processing time: 173 Days and 20.8 Hours
The early detection of colorectal cancer with effective screening is essential for reduction of cancer-specific mortality. The addition of fecal DNA testing in the armamentarium of screening methods already in clinical use launches a new era in the noninvasive part of colorectal cancer screening and emanates from a large number of previous and ongoing clinical investigations and technological advancements. In this review, we discuss the molecular rational and most important genetic alterations hallmarking the early colorectal carcinogenesis process. Also, representative DNA targets-markers and key aspects of their testing at the clinical level in comparison or/and association with other screening methods are described. Finally, a critical view of the strengths and limitations of fecal DNA tests is provided, along with anticipated barriers and suggestions for further exploitation of their use.
Core tip: The molecular DNA targets from genetic and epigenetic alterations hallmarking colorectal carcinogenesis are reviewed here in the context of fecal testing. Also, comparison with other screening methods in terms of limitations, advantages and future perspectives of fecal DNA tests are discussed.