Mohammad Yasin Zamanian
1,2* 
, Darmadi Darmadi
3, Razieh Darabi
4, Raed Fanoukh Aboqader Al-Aouadi
5, Mehraveh Sadeghi Ivraghi
6, Esra Küpeli Akkol
7* 1 Department of Physiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan 6718773654, Iran
2 Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan 6718773654, Iran
3 Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
4 Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan 6718773654, Iran
5 College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
6 School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
7 Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Ankara 06330, Türkiye
Abstract
Colorectal cancer (CRC) constitutes a significant global health challenge, accounting for a considerable proportion of cancer cases and associated mortality. Projections indicate a potential increase in new cases by 2040, attributed to demographic factors such as aging and population growth. Although advancements in the understanding of CRC pathophysiology have broadened treatment options, challenges such as drug resistance and adverse effects persist, highlighting the necessity for enhanced diagnostic methodologies. Timely detection markedly improves survival rates; however, colonoscopy, regarded as the gold standard for CRC screening, is constrained by its invasiveness and reliance on practitioner expertise. Consequently, the development of novel diagnostic approaches is imperative. Cancer biomarkers, which serve as indicators of cancer progression, show significant promise for improving diagnosis, prognosis, and treatment strategies. This study investigates molecular and cellular biomarkers, including proteins, DNA mutations, methylation markers, and microRNAs, that are pivotal in precision medicine and the monitoring of CRC progression. Additionally, emerging biomarkers such as circular RNAs (circRNAs) and long non-coding RNAs (lncRNAs) present opportunities for early detection. Current Food and Drug Administration (FDA)-approved CRC biomarkers reflect a shift towards personalized medicine, enhancing patient compliance and clinical outcomes. Nevertheless, further research is essential for the discovery of novel biomarkers and for deepening the understanding of CRC etiology, thereby advancing personalized care. Addressing standardization challenges will be crucial for ensuring global patient access to biomarker-based strategies.