Navigating the Colorectal Cancer Maze: Unveiling Pathways To Diagnosis, Management, Pathophysiology and Prevention

Abstract

Purpose of review: Colorectal cancer is the third most prevalent cancer globally and the second leading cause of cancer-related mortality. It typically develops over years through the progression of benign polyps to malignancy, driven by genetic alterations-either spontaneous or inherited. This review summarizes current knowledge on colorectal cancer, including its epidemiology, risk factors, diagnostic methods, treatment strategies, preventative measures, and research developments, while identifying knowledge gaps to guide future studies.

Recent findings: Colorectal cancer is influenced by numerous lifestyle-related risk factors, such as high-calorie diets, processed foods, red meat, smoking, obesity, and alcohol use. Colonoscopy, imaging tests, and biopsies remain essential for diagnosis, while the TNM staging system continues to guide therapeutic decisions. Treatment options range from early-stage surgical interventions to chemotherapy, radiotherapy, and targeted therapies in advanced stages, with neoadjuvant and adjuvant treatments offering improved outcomes. Experimental therapies, including regorafenib and cancer vaccines, are under investigation. Prevention strategies focus on healthy lifestyles and risk avoidance, alongside screening techniques including fecal occult blood tests, colonoscopy, and sigmoidoscopy. Screening programs emphasize individuals with genetic susceptibility, and clinical trials aim to enhance both screening and therapeutic approaches. Colorectal cancer poses a substantial global health challenge. Advances in diagnostics, treatment, and prevention are promising, but further research is needed to improve management strategies and address gaps in screening. Lifestyle changes and early detection through targeted screening remain critical for reducing the disease burden worldwide.

Keywords: Colorectal cancer; Epidemiology; Management; Pathophysiology; Vaccine-based immunotherapy.