Chua MWE, Chan DKH. Challenges and proposed solutions to the adoption of cell free DNA in screening, detecting and prognosticating colorectal cancer. World J Gastrointest Oncol 2025; 17(8): 106663 [DOI: 10.4251/wjgo.v17.i8.106663]
Corresponding Author of This Article
Dedrick Kok-Hong Chan, Assistant Professor, Department of Colorectal Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. surckhd@nus.edu.sg
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Aug 15, 2025; 17(8): 106663 Published online Aug 15, 2025. doi: 10.4251/wjgo.v17.i8.106663
Challenges and proposed solutions to the adoption of cell free DNA in screening, detecting and prognosticating colorectal cancer
Megan Wern-Ee Chua, Dedrick Kok-Hong Chan
Megan Wern-Ee Chua, Dedrick Kok-Hong Chan, Department of Colorectal Surgery, National University Hospital, Singapore 119074, Singapore
Author contributions: Chua MWE was responsible for performing a literature review, writing the initial draft of the review, and designing the figure; Chan DKH was responsible for writing the review; Chua MWE and Chan DKH selected eligible studies and final approval of the review; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dedrick Kok-Hong Chan, Assistant Professor, Department of Colorectal Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. surckhd@nus.edu.sg
Received: March 4, 2025 Revised: April 8, 2025 Accepted: July 4, 2025 Published online: August 15, 2025 Processing time: 163 Days and 14.3 Hours
Core Tip
Core Tip: Cell free DNA (cfDNA) carries information about colorectal cancer-specific genetic and epigenetic alterations which can aid in screening, detection and prognostication. Detection of genetic alterations is made difficult by low signal-to-noise ratio owing to an abundance of background non-tumorigenic mutations. Low amounts of cfDNA in healthy individuals negatively affects the sequencing performance and limit of detection of assays making screening non-feasible. One solution is to harvest cfDNA from peritoneal fluid or stool as this is more representative of the primary tumour compared to plasma-derived cfDNA. Alternatively, increasing the sensitivity of sequencing technologies would allow for the detection of low frequency mutations.
