Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
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 [PMID: 40837751 DOI: 10.4251/wjgo.v17.i8.106663]
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.
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 14.9 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.
