Chengcheng Liu

Ph.D

The Second Affiliated Hospital, Zhejiang University School of Medicine

Assistant researcher

PLCO (Learn more about this study)

PLCO-1083

Oct 27, 2022

Integrating genetic susceptibility, blood biomarkers, and traditional factors to develop risk-adapted colonoscopy surveillance strategies

Colorectal cancer (CRC) is the third most common cause of cancer death in both men and women in the United States and ranks second when men and women are combined. Although screening has contributed to recent declines in CRC incidence and mortality, the increasing utilization of colonoscopy poses new clinical challenges. The increase in colonoscopy utilization and resulting detection of adenomas, the acknowledged precursor of most CRC, will stimulate increasing use of surveillance colonoscopy, or epeated colonoscopic monitoring of subjects for recurrent adenomas. The current guidelines recommended risk-tailored surveillance. However, definition for risk is blunt and supported by largely empirical evidence based on pathologic classifications, which resulted in the improperly use of surveillance colonoscopy in clinical practice. Thus, novel approaches to improve risk stratification of individuals after resection of adenoma for colonoscopic surveillance is a highly significant warranted.
It has been well recognized that exogenous factors (including diet, nutrition, lifestyle, the environment, etc.), and endogenous factors (including genetic variations, circulating biomarkers) contribute to the progression of colorectal precancer lesions. As we all know, genetic susceptibility contributes to CRC risk and approximately 100 variants have been identified in genome-wide association studies. In addition, several groups of blood biomarkers have been implicated in the early stage of colorectal carcinogenesis, including those related to inflammation, metabolic disturbances, and sex hormones.
Exploring the profiles of genetic susceptibility and circulating biomarkers associated with the development of CRC and then building risk prediction model for the progression from precancerous colorectal lesions to CRC is helpful to develop risk-tailored surveillance. Expected results may provide new insights into how to prevent interval CRC more effectively through improved risk stratification for colonoscopy and inform our understanding of pathways fundamental to tumor morphology and progression.