• I. Karasev N.N. Blokhin National Medical Research Center of Oncology
  • O. Malikhova N.N. Blokhin National Medical Research Center of Oncology
  • V. Vereshak N.N. Blokhin National Medical Research Center of Oncology
  • A. Stroganova N.N. Blokhin National Medical Research Center of Oncology


сolorectal cancer, microbiota, molecular genetic research, serrated neoplasia, biomarkers, endoscopy, screening


Colorectal cancer (CRC) is one of the leading causes of death from cancer in many countries of the world, both in men and women, and these rates are on the rise. About 1.8 million new colorectal cancer cases were diagnosed in 2018, and they also account for 8% of all cancer deaths. The 5-year survival rates for patients with stage I and II cancer are 95% and 82%. Despite the continuous development of diagnostic and therapeutic methods (for example, colonoscopy, flexible sigmoidoscopy, and tests based on chromatographic analysis), colorectal cancer is often detected at a stage of significant spread. In order to reduce morbidity and mortality, timely detection and treatment of precancerous conditions of the colon is necessary.

Screening plays an important role in the detection of colorectal cancer, and its early diagnosis has a significant impact on survival rates. Moreover, obligate precancerous lesions can be diagnosed and removed.

Colorectal cancer in most cases develops as a result of the degeneration of adenomatous formations or along the jagged path Considering that the average time of development of adenocarcinoma from precancer takes about 10 years, changes in the intestinal microflora may be a promising marker for screening precancerous conditions of the colon. The commensal gut microbiota plays an important role in various systemic functions, which include modulation of the immune system, neurohormonal activity, intestinal barrier, and epithelial integrity. Immune dysregulation, dysbiosis, and epithelial destruction contribute to colorectal cancer carcinogenesis. Detecting changes in DNA can also be used to screen for colorectal cancer. Fragments of circulating methylated DNA are found in the blood of patients with colorectal cancer. But now, research shows low sensitivity.

Numerous molecular genetic studies of colorectal cancer have revealed a number of genetic disorders, most of which are inherited in an autosomal dominant manner and significantly increase the risk of neoplasia.


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