Diagnostic Pathways and Molecular Biomarkers in Colorectal Cancer: Current Evidence and Perspectives in Poland

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Abstract
Colorectal cancer (CRC) is the third most commonly diagnosed malignancy worldwide and remains a major challenge in contemporary oncology, where early detection is critical for improving treatment outcomes and survival. Despite significant progress in diagnostics and therapy, the epidemiology, risk factors, and molecular mechanisms driving CRC development continue to be intensively investigated. This paper provides an overview of current trends in CRC diagnosis and management, with particular emphasis on advances in molecular medicine and biological sciences. Screening recommendations in Poland are discussed, comparing invasive methods—such as colonoscopy, sigmoidoscopy, and CT colonography—with non-invasive stool-based tests (FOBT, FIT, sDNA-FIT), and evaluating their sensitivity, specificity, and impact on mortality reduction. Key tumor markers with diagnostic, prognostic, and predictive value, including CEA, CA19-9, mSEPT9, ctDNA, TPS, TAG-72, CTCs, and circulating microRNAs, as well as p53 and PTEN proteins, are reviewed in the context of their clinical utility in early detection, disease monitoring, and treatment response assessment. The analysis also highlights the epidemiological situation in Poland and underscores the growing importance of integrating molecular biomarkers with traditional diagnostic methods, which may ultimately support the development of more precise and individualized clinical management strategies in the future.

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