Colorectal cancer: a blood test to identify patients at risk of recurrence

By Ana Espino | Published on March 2nd, 2026 | 3 min read


Colorectal cancer remains a disease characterized by heterogeneous clinical outcomes, with varying risks of recurrence and mortality among patients. Despite the use of standard prognostic factors such as tumor stage and age, the ability to accurately predict individual disease progression remains limited. This uncertainty highlights the need for complementary biological tools capable of identifying, at the time of diagnosis, patients at increased risk of recurrence or death. In this context, the exploration of blood-based markers grounded in epigenetic mechanisms represents a promising avenue to improve prognostic stratification.  

A study conducted by researchers at the Moffitt Cancer Center, published on February 1, 2026, in Clinical Epigenetics, evaluated the potential of blood-based markers to predict clinical outcomes in patients with colorectal cancer. The objective was to determine whether these DNA markers—derived from epigenetic signatures associated with circulating proteins—could identify patients at higher risk of recurrence or death beyond the clinical factors currently used in routine practice.  

Analysis of blood protein epiScores  

The researchers analyzed blood DNA markers referred to as protein epiScores. These scores are based on epigenetic signatures that estimate protein expression from DNA methylation profiles. Associations between these markers and clinical outcomes were assessed to identify the scores most strongly linked to prognosis. Their added value was then compared with that of standard clinical factors, particularly cancer stage and patient age. Predictive performance was evaluated in terms of accuracy for recurrence and overall survival.  

Four protein epiScores were identified as strongly associated with poor prognosis. Patients with high levels of these scores had a 60% to 70% increased risk of recurrence. Among these markers, LGALS3BP stood out for its association with overall survival: higher scores were linked to an 80% increase in the risk of death during follow-up.

Integrating these epiproteomic scores with traditional clinical factors resulted in a modest but statistically significant improvement in predictive performance. The accuracy of recurrence prediction increased from 64% to 70%, while overall survival prediction improved from 70% to 75% when epiScores were added to clinical models.  

Biological implications and clinical perspectives  

These findings indicate that protein epiScores provide complementary biological information beyond conventional prognostic tools. The identified markers appear to reflect processes related to immune function, angiogenesis, and coagulation—dimensions not captured by standard clinical factors. Their integration may therefore refine risk assessment in patients with colorectal cancer.  

Although these results require validation in other patient populations, they demonstrate the potential of a simple pre-treatment blood sample to enhance prognostic stratification. In the long term, this approach could contribute to more individualized follow-up and therapeutic strategies in colorectal cancer.        

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About the Author – Elodie Vaz
Health journalist, CFPJ graduate (2023).
Élodie explores the marks diseases leave on bodies and, more broadly, on human life. A registered nurse since 2010, she spent twelve years at patients’ bedsides before exchanging her stethoscope for a notebook. She now investigates the links between environment and health, convinced that the vitality of life cannot be reduced to that of humans alone.