The epigenetic and genetic mechanisms of colorectal cancer pathogenesis

Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality worldwide. Owing to the lack of obvious early symptoms, CRC is often diagnosed at an advanced stage, highlighting the limitations of current early diagnostic and therapeutic approaches. Accumulating evidence suggests that the accumulation of various epigenetic and genetic mutations in intestinal epithelial cells is a key driver of the occurrence and progression of precancerous lesions in CRC. Epigenetics refers to molecular modifications that influence gene expression without altering the DNA sequence and plays a crucial role in gene activation or repression. Epigenetic mechanisms include DNA methylation, histone modification, non-coding RNAs, and chromatin remodeling. Furthermore, epigenetic alterations can serve as effective biomarkers for the development of diagnostic and therapeutic strategies in cancer. Based on the unique biological characteristics of epigenetics, this review takes CRC-associated genetic mutations as a starting point to elucidate the role of epigenetic mechanisms in CRC progression and to explore their potential in clinical applications, with the aim of providing new insights for the early screening and treatment of colorectal cancer.