Blood Test May Predict Colorectal Cancer Risk

Recent research suggests that a simple blood test taken before surgery could identify colorectal cancer patients at higher risk of recurrence or metastasis. Scientists from the Korea Advanced Institute of Science and Technology, Gangnam Severance Hospital, and Asan Medical Center conducted the study.

The study revealed that colorectal cancer alters the body’s metabolism, which can be detected in the blood. The researchers focused on the interactions between amino acids, forming a metabolic network instead of analyzing individual amino acids. This approach might offer a more comprehensive view of cancer progression.

Cancer cells need nutrients to grow, using amino acids for protein building and energy production. Historically, research measured individual amino acid levels in blood samples. The new study explored relationships among 18 amino acids using fluorine-19 nuclear magnetic resonance spectroscopy. Findings showed that as colorectal cancer advanced, the amino acid network reorganized significantly.

Notably, branched-chain amino acids, like valine and leucine, essential for muscle and energy metabolism, decreased as the disease progressed. In contrast, amino acids such as glycine and serine, used by cancer cells for DNA synthesis and growth, became more prominent. Glycine’s abundance in the bloodstream increased with cancer progression, indicating widespread metabolic changes.

The researchers integrated these amino acid interactions into machine-learning models to identify patients prone to recurrence or metastasis. Models based on amino acid interactions proved more effective than those using carcinoembryonic antigen (CEA), a common colorectal cancer marker. Combining CEA with amino acid data improved the model’s performance, surpassing models relying on single amino acid levels.

Professor Ji Min Lee, who led the study, stated that this approach could lead to precision medicine technologies predicting recurrence risk more accurately. These technologies might help personalize treatment strategies.

“We hope this will lead to new precision medicine technologies that can predict recurrence risk more accurately using a blood sample alone and help establish personalized treatment strategies,” said Professor Lee.

Experts caution that more validation is required before impacting patient care. Dr. Michael F. Driscoll, director of the Gastrointestinal Malignancy Program at Norton Healthcare, emphasized the need for larger studies to confirm the results. He noted that integrating blood-based biomarkers into clinical practice often faces insurance coverage challenges.

“The challenge of incorporating blood-based biomarker assays into clinical practice is often related to insurance coverage, as many of these tests are considered ‘experimental’,” Dr. Driscoll noted.

Currently, many gastrointestinal oncologists use circulating tumor DNA tests post-surgery to gauge recurrence risk, recognized as the most sensitive and validated method in numerous studies.

While not yet a routine test, the findings hint at the potential of amino acid interactions to serve as a valuable blood-based biomarker for tracking colorectal cancer progression and risk assessment.

The research identified Ji-Yeon Lee and Dr. Jumi Kim as co-first authors, and Professors Ji Min Lee, Hyunwoo Kim, and Eun Jung Park as co-corresponding authors. The results were published in Advanced Science on June 9, 2026.