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Ways to improve the diagnosis and treatment of early colorectal cancer: a literature review and a clinical case study

https://doi.org/10.21294/1814-4861-2025-24-3-114-123

Abstract

The development of effective, highly sensitive and highly specific approaches to early detection of colorectal cancer is the basis for the timely use of various targeted interventions that can effectively solve patients’ problems, minimizing the impact on their quality of life. Endoscopic diagnostic and therapeutic techniques continue to play a critical role in improving cancer outcomes and are continually being reviewed and improved to increase detection rates of colorectal cancer.

The aim of the study was to analyze and summarize the current scientific literature describing promising developments in early diagnosis and treatment of colorectal cancer, as well as to describe a case report demonstrating the importance of high-quality diagnostics for selecting a therapeutic strategy for colorectal cancer.

Material and Methods. The literature search was conducted in Pubmed, Google Scholar, and Elibrary.ru databases, focusing on articles published between 2016 and 2025, using the key words “colorectal cancer”, “colorectal cancer”, “CT-colonography”, “colonoscopy”. Priority was given to the studies describing the improvement of screening tools for detecting colorectal neoplasia. Of the 100 publications, 41 were selected for this review.

Results. Precise optical diagnosis of colorectal polyps, including the ability to predict polyp histology in real time during colonoscopy, appears to be the most promising approach for detecting even small colorectal lesions. This approach can potentially allow for the abandonment of forceps biopsy reducing the incidence of misdiagnosis (as demonstrated in the described case report).

Conclusion. To develop strategies for improving early detection and treatment of colorectal cancer, it is necessary to take into account the fact that the human, diagnostic and therapeutic potential in different regions of Russia varies significantly. Researchers should prioritize developing their own diagnostic experience, removing economic barriers to effective colorectal cancer detection, and developing rational ways to improve therapeutic approaches within regional health care settings.

About the Authors

V. O. Gaulikà
Surgut District Clinical Hospital
Russian Federation

Vladislav O. Gaulikа - MD, Oncologist.

14, Energetikov St., Surgut, 628408



A. M. Parsadanyan
Khanty-Mansiysk State Medical Academy
Russian Federation

Ararat M. Parsadanyan - MD, DSc, Professor, Head of the Department of Obstetrics, Gynecology and Oncology.

40, Mira, Khanty-Mansiysk, 628011



K. K. Kostanyan
Surgut District Clinical Hospital
Russian Federation

Karen K. Kostanyan - MD, Oncologist.

14, Energetikov St., Surgut, 628408



References

1. Fedorov V.E., Podelyakin K.A. Epidemiological aspects of colorectal cancer. Medical Almanac. 2017; 4: 145–48. (in Russian). EDN: ZIZZTR.

2. Kulaev K.I., Vazhenin A.V., Rostovtsev D.M., Kim YA., Zaitsev P.A., Privalov A.V., Valik A.V., Zuykov K.S., Yusupov I.M., Popova I.A., Pushkarev E.A. Artificial intelligence in colon neoplasm diagnosis: development, implementation of technology, and initial results. Problems in Oncology. 2023; 69(2): 292–99. (in Russian). doi: 10.37469/0507-3758-2023-69-2-292-299. EDN: OPTNWC.

3. Gaulika V.O., Parsadanyan A.M., Kuznetsov E.V. The role of fibrocolonoscopic diagnosis in assessing the risk of progression of early colorectal cancer. Medicine. Sociology. Philosophy. Applied research. 2023; 5: 4–7. (in Russian). EDN: BKHTPD.

4. Sidorova A.N., Klimenko V.N., Sherbakov A.M., Tkachenko O.B. Morden tactic in diagnosis and treatment of early colon cancer (review of literature). The Scientific Notes of Pavlov University. 2020; 27(4): 28–37. (in Russian). doi: 10.24884/1607-4181-2020-27-428-37. EDN: ZOKPKD.

5. Xu H., Tang R.S.Y., Lam T.Y.T., Zhao G., Lau J.Y.W., Liu Y., Wu Q., Rong L., Xu W., Li X., Wong S.H., Cai S., Wang J., Liu G., Ma T., Liang X., Mak J.W.Y., Xu H., Yuan P., Cao T., Li F., Ye Z., Shutian Z., Sung J.J.Y. Artificial Intelligence-Assisted Colonoscopy for Colorectal Cancer Screening: A Multicenter Randomized Controlled Trial. Clin Gastroenterol Hepatol. 2023; 21(2): 337–46. doi: 10.1016/j.cgh.2022.07.006.

6. Spadaccini M., Troya J., Khalaf K., Facciorusso A., Maselli R., Hann A., Repici A. Artificial Intelligence-assisted colonoscopy and colorectal cancer screening: Where are we going? Dig Liver Dis. 2024; 56(7): 1148–55. doi: 10.1016/j.dld.2024.01.203.

7. Wallace M.B., Sharma P., Bhandari P., East J., Antonelli G., Lorenzetti R., Vieth M., Speranza I., Spadaccini M., Desai M., Lukens F.J., Babameto G,. Batista D., Singh D., Palmer W., Ramirez F., Palmer R., Lunsford T., Ruff K., Bird-Liebermann E., Ciofoaia V., Arndtz S., Cangemi D., Puddick K., Derfus G., Johal A.S., Barawi M., Longo L., Moro L., Repici A., Hassan C. Impact of Artificial Intelligence on Miss Rate of Colorectal Neoplasia. Gastroenterology. 2022; 163(1): 295–304. doi: 10.1053/j.gastro.2022.03.007.

8. Lui T.K.L., Guo C.G., Leung W.K. Accuracy of artificial intelligence on histology prediction and detection of colorectal polyps: a systematic review and meta-analysis. Gastrointest Endosc. 2020; 92(1): 11–22. doi: 10.1016/j.gie.2020.02.033.

9. Hassan C., Spadaccini M., Iannone A., Maselli R., Jovani M., Chandrasekar V.T., Antonelli G., Yu H., Areia M., Dinis-Ribeiro M., Bhandari P., Sharma P., Rex D.K., Rösch T., Wallace M., Repici A. Performance of artificial intelligence in colonoscopy for adenoma and polyp detection: a systematic review and meta-analysis. Gastrointest Endosc. 2021; 93(1): 77–85. doi: 10.1016/j.gie.2020.06.059.

10. Barua I., Vinsard D.G., Jodal H.C., Løberg M., Kalager M., Holme Ø., Misawa M., Bretthauer M., Mori Y. Artificial intelligence for polyp detection during colonoscopy: a systematic review and meta-analysis. Endoscopy. 2021; 53(3): 277–84. doi: 10.1055/a-1201-7165.

11. Repici A., Spadaccini M., Antonelli G., Correale L., Maselli R., Galtieri P.A., Pellegatta G., Capogreco A., Milluzzo S.M., Lollo G., Di Paolo D., Badalamenti M., Ferrara E., Fugazza A., Carrara S., Anderloni A., Rondonotti E., Amato A., De Gottardi A., Spada C., Radaelli F., Savevski V., Wallace M.B., Sharma P., Rösch T., Hassan C. Artificial intelligence and colonoscopy experience: lessons from two randomised trials. Gut. 2022; 71(4): 757–65. doi: 10.1136/gutjnl-2021-324471.

12. Forbes N. Minimal Incremental Benefits of Computer-Aided Optical Diagnosis of Colorectal Polyp Histology in a Large Prospective Cohort. Gastroenterology. 2025; 168(2): 418–19. doi: 10.1053/j.gastro.2024.07.037.

13. Kashihara T., Muguruma N., Fujimoto S., Miyamoto Y., Sato Y., Takayama T. Recent Advances in Molecular Imaging of Colorectal Tumors. Digestion. 2021; 102(1): 57–64. doi: 10.1159/000512168.

14. Teramoto A., Hamada S., Ogino B., Yasuda I., Sano Y. Updates in narrow-band imaging for colorectal polyps: Narrow-band imaging generations, detection, diagnosis, and artificial intelligence. Dig Endosc. 2023; 35(4): 453–70. doi: 10.1111/den.14489.

15. Matsumura T., Ebigbo A., Römmele C., Ikematsu H., Ishigami H., Suzuki T., Harada H., Yada T., Takatori Y., Takeuchi M., Okimoto K., Akizue N., Maruoka D., Kitagawa Y., Minamide T., Iwaki T., Amano Y., Matsusaka K., Nagashima K., Maehata T., Yahagi N., Messmann H., Kato N. Diagnostic Value of Adding Magnifying Chromoendoscopy to Magnifying Narrow-Band Imaging Endoscopy for Colorectal Polyps. Clin Gastroenterol Hepatol. 2023; 21(10): 2551–59. doi: 10.1016/j.cgh.2023.01.028.

16. Houwen B.B.S.L., Hazewinkel Y., Giotis I., Vleugels J.L.A., Mostafavi N.S., van Putten P., Fockens P., Dekker E.; POLAR Study Group. Computer-aided diagnosis for optical diagnosis of diminutive colorectal polyps including sessile serrated lesions: a real-time comparison with screening endoscopists. Endoscopy. 2023; 55(8): 756–65. doi: 10.1055/a2009-3990.

17. Khalaf K., Fujiyoshi M.R.A., Spadaccini M., Rizkala T., Ramai D., Colombo M., Fugazza A., Facciorusso A., Carrara S., Hassan C., Repici A. From Staining Techniques to Artificial Intelligence: A Review of Colorectal Polyps Characterization. Medicina (Kaunas). 2024; 60(1): 89. doi: 10.3390/medicina60010089.

18. Glover B., Teare J., Patel N. The Status of Advanced Imaging Techniques for Optical Biopsy of Colonic Polyps. Clin Transl Gastroenterol. 2020; 11(3): e00130. doi: 10.14309/ctg.0000000000000130.

19. Rogalla S., Flisikowski K., Gorpas D., Mayer A.T., Flisikowska T., Mandella M.J., Ma X., Casey K.M., Felt S.A., Saur D., Ntziachristos V., Schnieke A., Contag C.H., Gambhir S.S., Harmsen S. Biodegradable fluorescent nanoparticles for endoscopic detection of colorectal carcinogenesis. Adv Funct Mater. 2019; 29(51): 1904992. doi: 10.1002/adfm.201904992.

20. Uddin M.J., Niitsu H., Coffey R.J., Marnett L.J. Development of Pluoronic nanoparticles of fluorocoxib A for endoscopic fluorescence imaging of colonic adenomas. J Biomed Opt. 2023; 28(4): 040501. doi: 10.1117/1.JBO.28.4.040501.

21. He L., Guo L., Hu C. Computed Tomography Colonography Versus Standard Optical Colonoscopy for the Detection of Colorectal Polyp in Patients Who Faced Curative Surgery for Colorectal Cancer: A Diagnostic Performance Study. Cancer Invest. 2020; 38(6): 339–48. doi: 10.1080/07357907.2020.1771724.

22. Sha J., Chen J., Lv X., Liu S., Chen R., Zhang Z. Computed tomography colonography versus colonoscopy for detection of colorectal cancer: a diagnostic performance study. BMC Med Imaging. 2020; 20(1): 51. doi: 10.1186/s12880-020-00446-7.

23. Chini A., Manigrasso M., Cantore G., Maione R., Milone M., Maione F., De Palma G.D. Can Computed Tomography Colonography Replace Optical Colonoscopy in Detecting Colorectal Lesions?: State of the Art. Clin Endosc. 2022; 55(2): 183–90. doi: 10.5946/ce.2021.254.

24. Meshcheryakov A.I., Gurova N.Yu., Burkov S.G., Pugacheva O.G.L., Balashov A.V., Zolina A.S. Comparison of computed tomographic colonography (virtual colonoscopy) efficacy in detecting colorectal lesions using two schemes of preparation: with fecal tagging and without it. Annals of Surgery. 2018; 23 (1): 33–41. (in Russian)]. doi: 10.18821/1560-9502-2018-23-1-33-41. EDN: LAOQCL.

25. Hanly P., Skally M., Fenlon H., Sharp L. Cost-effectiveness of computed tomography colonography in colorectal cancer screening: a systematic review. Int J Technol Assess Health Care. 2012; 28(4): 415–23. doi: 10.1017/S0266462312000542.

26. van der Meulen M.P., Lansdorp-Vogelaar I., Goede S.L., Kuipers E.J., Dekker E., Stoker J., van Ballegooijen M. Colorectal Cancer: Costeffectiveness of Colonoscopy versus CT Colonography Screening with Participation Rates and Costs. Radiology. 2018; 287(3): 901–11. doi: 10.1148/radiol.2017162359.

27. Kamrani A., Nasiri H., Hassanzadeh A., Ahmadian Heris J., Mohammadinasab R., Sadeghvand S., Sadeghi M., Valedkarimi Z., Hosseinzadeh R., Shomali N., Akbari M. New immunotherapy approaches for colorectal cancer: focusing on CAR-T cell, BiTE, and oncolytic viruses. Cell Commun Signal. 2024; 22(1): 56. doi: 10.1186/s12964-023-01430-8.

28. Zhao Y., Deng J., Rao S., Guo S., Shen J., Du F., Wu X., Chen Y., Li M., Chen M., Li X., Li W., Gu L., Sun Y., Zhang Z., Wen Q., Xiao Z., Li J. Tumor Infiltrating Lymphocyte (TIL) Therapy for Solid Tumor Treatment: Progressions and Challenges. Cancers (Basel). 2022; 14(17): 4160. doi: 10.3390/cancers14174160.

29. Hu Z., Li Y., Yang J., Liu J., Zhou H., Sun C., Tian C., Zhu C., Shao M., Wang S., Wei L., Liu M., Li S., Wang J., Xu H., Zhu W., Li X., Li J. Improved antitumor effectiveness of oncolytic HSV-1 viruses engineered with IL-15/IL-15Rα complex combined with oncolytic HSV1-aPD1 targets colon cancer. Sci Rep. 2024; 14(1): 23671. doi: 10.1038/s41598-024-72888-w.

30. Jabalera Y., Garcia-Pinel B., Ortiz R., Iglesias G., Cabeza L., Prados J., Jimenez-Lopez C., Melguizo C. Oxaliplatin-Biomimetic Magnetic Nanoparticle Assemblies for Colon Cancer-Targeted Chemotherapy: An In Vitro Study. Pharmaceutics. 2019; 11(8): 395. doi: 10.3390/pharmaceutics11080395.

31. Polyanskaya E.A., Fedyanin M.Yu., Tryakin A.A., Tjulandin S.A. Colorectal cancer, screening: achievements и opportunities. Oncologic Coloproctology. 2018; 8(4): 11–29. (in Russia). doi: 10.17650/2220-3478-2018-8-4-11-29. EDN: YRNZCH.

32. Rozani S., Lykoudis P.M. Overcoming geographical and socioeconomic limitations in colorectal cancer screening. World J Gastrointest Oncol. 2024; 16(5): 1683–89. doi: 10.4251/wjgo.v16.i5.1683.

33. Bakulin I.G., Zharkov A.V., Zhuravleva M.S., Serkova M.Yu. Colorectal cancer screening: current status and future prospects. Russian Journal of Preventive Medicine. 2023; 26(12): 1218. (in Russian)]. doi: 10.17116/profmed20232612112. EDN: CKWLNQ.

34. Anufrieva E.V., Demidov D.A., Chekasina E.S. Project approach to organizing colorectal cancer screening as a basis for improving public health. Public Health and Life Environment. 2023; 31(11): 7–14. (in Russian). doi: 10.35627/2219-5238/2023-31-117-14. EDN: VRUYDA.

35. The state of oncological care to the population of Russia in 2022. Ed. A.D. Kaprin, V.V. Starinsky, A.O. Shakhzadova. Moscow, 2023. 239 p. (In Russian). ISBN: 978-5-85502-283-4.

36. Mitrakov A.A., Kryazhov V.A., Smirnova R.S., Zhelezin O.V., Pegov R.G., Terekhov V.M. Endoscopic methods for treatment of colorectal neoplasia. Oncology Bulletin of the Volga region. 2018; 3(35): 57–61. (in Russian). EDN: VMMIDY.

37. Malikhova O.A., Zavyalov D.V., Kashin S.V., Shishin K.V., Ilyashenko M.G., Kireev S.U., Mikhin A.I., Sidorova A.N., Malikhov A.G. Guidelines for the endoscopic diagnosis, treatment and follow-up of patients with epithelial neoplasms of the colon. 2022. Modern Oncology. 2023; 25(1): 5–14. (in Russian). doi: 10.26442/18151434.2023.1.201972. EDN: XJXYNC.

38. Fedorenko A.A., Pavlov P.V., Kiryukhin A.P., Tertychnyy A.S. Immediate Results of Colonic Flat Epithelial Neoplasms Removal Using Diathermic Snare Endoscopic Mucosal Resection and Mucosectomy Combined with Dissection in the Submucosal Layer: Comparative Assessment. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2023; 33(4): 14–23. (in Russian). doi: 10.22416/1382-4376-2023-33-4-14-23. EDN: KLTGYQ.

39. Dumoulin F.L., Hildenbrand R. Endoscopic resection techniques for colorectal neoplasia: Current developments. World J Gastroenterol. 2019; 25(3): 300–307. doi: 10.3748/wjg.v25.i3.300.

40. Khalin K.D., Agapov M.Yu., Zvereva L.V. Diagnostic value of preoperative biopsy in differential diagnosis of epithelial colorectal tumors. Pacific Medical Journal. 2018; 1: 41–43. (in Russian). EDN: NTTYPJ. doi: 10.17238/PmJ1609-1175.2018.1.41-43.

41. Rath T., Tontini G.E., Vieth M., Nägel A., Neurath M.F., Neumann H. In vivo real-time assessment of colorectal polyp histology using an optical biopsy forceps system based on laser-induced fluorescence spectroscopy. Endoscopy. 2016; 48(6): 557–62. doi: 10.1055/s-0042-102251.


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For citations:


Gaulikà V.O., Parsadanyan A.M., Kostanyan K.K. Ways to improve the diagnosis and treatment of early colorectal cancer: a literature review and a clinical case study. Siberian journal of oncology. 2025;24(3):114-123. (In Russ.) https://doi.org/10.21294/1814-4861-2025-24-3-114-123

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ISSN 1814-4861 (Print)
ISSN 2312-3168 (Online)