Colorectal cancer (CRC) is the second leading cause of cancer death worldwide that
is attributed to gradual long-term accumulation of both genetic and epigenetic
changes. To reduce the mortality rate of CRC and to improve treatment efficacy, it
will be important to develop accurate noninvasive diagnostic tests for screening,
acute and personalized diagnosis. Epigenetic changes such as DNA methylation play
an important role in the development and progression of CRC. Over the last decade,
a panel of DNA methylation markers has been reported showing a high accuracy and
reproducibility in various semi-invasive or noninvasive biosamples. Research to
obtain comprehensive panels of markers allowing a highly sensitive and differentiating diagnosis of CRC is ongoing. Moreover, the epigenetic alterations for cancer therapy, as a precision medicine strategy will increase their therapeutic potential over
time. Here, we discuss the current state of DNA methylation-based biomarkers and
their impact on CRC diagnosis. We emphasize the need to further identify and stratify methylation-biomarkers and to develop robust and effective detection methods
that are applicable for a routine clinical setting of CRC diagnostics particularly at the
early stage of the disease
