Advancing Inflammatory Bowel Disease-Driven Colorectal Cancer Management: Molecular Insights and Endoscopic Breakthroughs Towards Precision Medicine
Marietta Iacucci, Olga Maria Nardone, Ilaria Ditonno, Ivan Capobianco, Cecilia Lina Pugliano, Yasuharu Maeda, Snehali Majumder, Irene Zammarchi, Giovanni Santacroce, Subrata Ghosh
Abstract
Colorectal cancer (CRC) is a serious complication of inflammatory bowel disease (IBD), significantly contributing to increased mortality and health care burden. Although advances in IBD management have led to a decline in CRC incidence, it remains a major clinical concern. Recent breakthroughs in advanced imaging, molecular diagnostics, and artificial intelligence are poised to revolutionize precision medicine in IBD-associated CRC, potentially reducing neoplastic risk and improving patient outcomes. This review explores emerging concepts in colitis-associated cancer pathogenesis, including the intricate interplay between diet, microbiome alterations, and intestinal barrier dysfunction in CRC progression. Additionally, it highlights cutting-edge diagnostic and assessment techniques, such as ultra-high magnification endoscopy, and new spatial biology platforms for assessing intestinal barrier integrity and molecular biomarkers, such as microRNAs and liquid biopsy. The future of IBD-related CRC management will incorporate a holistic, multi-integrated approach, combining artificial intelligence-driven diagnostics, omics data integration, endoscopic and surgical innovations, and nanotechnology-based therapies. This paradigm shift aims to enhance precision medicine, promoting organ-sparing approaches, improved diagnostics, and personalized cancer treatment with the potential to reduce CRC risk.