Colorectal adenocarcinoma — master index¶
Last curated: 2026-10-26 · status: sweep pending independent audit · 6 curated and 12 draft wiki pages · 345-paper master bibliography · 6 landmark-paper notes · 39-document guideline registry · 143 statistics rows · 39 live-verified NCT records · 10 patient organizations verified worldwide · 31 open questions + 12 unconnected-dots junctions
The condition in five sentences. Colorectal adenocarcinoma is not one disease but a family of epithelial malignancies arising through conventional adenoma–carcinoma, serrated and inherited pathways, with chromosomal instability, mismatch-repair deficiency and stromal/immune context shaping phenotype (Vogelstein 1988, PMID 2841597; Guinney 2015, PMID 26457759). Its global burden is high and unequally distributed, while rising young-onset incidence remains causally unresolved (Morgan 2023, PMID 36604116; Spaander 2023, PMID 37105987). Screening can prevent cancer by removing precursors or detect it earlier, but population benefit depends on participation, repeat adherence and completion of diagnostic colonoscopy after an abnormal result (Bretthauer 2022, PMID 36214590; Doubeni 2024, PMID 39028667). Surgery anchors localized disease; adjuvant oxaliplatin, total neoadjuvant rectal strategies, organ preservation and metastasis-directed treatment are selected by anatomic stage, biology, fitness and patient priorities (André 2015, PMID 26527776; Bahadoer 2021, PMID 33301740; Verheij 2024, PMID 37883738). Metastatic therapy is increasingly biomarker-defined, yet the largest frontiers remain proving ctDNA-guided intervention, expanding immunotherapy beyond MSI-high/dMMR disease, making precision care equitable and measuring bowel, sexual, neurologic, financial and surveillance burdens alongside survival (André 2020, PMID 33264544; Tie 2022, PMID 35657320; Rutherford 2020, PMID 32335745).
Start here: overview · Research frontier: open questions · Source ledger: bibliography · Build history: log
Reading paths¶
| Need | Suggested path |
|---|---|
| New diagnosis / clinical map | Overview → Pathology, staging and workup → Guidelines |
| Prevention and screening | Epidemiology → Adenoma and serrated pathways → Screening |
| Localized colon cancer | Pathology and staging → Localized colon cancer → Biomarkers and liquid biopsy |
| Localized rectal cancer | Pathology and staging → Localized rectal cancer → Survivorship |
| Metastatic disease | Metastatic systemic therapy → Precision oncology → Liver and lung metastasis |
| Molecular biology | Carcinogenic pathways → Molecular subtypes and microenvironment → Precision oncology |
| Inherited risk | Hereditary syndromes and genetics → Screening → Patient experience |
| Living with and beyond treatment | Survivorship → Patient experience → Patient-voice themes |
| Urgent complications | Red flags and safety → Pathology and workup |
| What is still unknown | Clinical-trials landscape → Open questions → Statistics sourcebook |
Canonical wiki pages¶
All pages passed the separate 2026-08-30 audit. Twelve pages changed in the 2026-10-12, 2026-10-19 and 2026-10-26 sweeps and await independent review.
| File | Scope | Status |
|---|---|---|
| overview.md | Carcinogenesis, burden, screening, stage and treatment map | curated |
| pathology-staging-and-diagnostic-workup.md | Histology, TNM, imaging, CEA, pathology quality and molecular workup | curated |
| epidemiology-and-burden.md | Incidence, mortality, geography, disparities and young-onset trends | draft |
| adenoma-carcinoma-and-serrated-pathways.md | APC sequence, serrated lesions, field effects and prevention biology | curated |
| molecular-subtypes-and-tumor-microenvironment.md | CMS, chromosomal instability, MSI and immune/stromal biology | curated |
| hereditary-syndromes-and-genetics.md | Lynch syndrome, FAP, polyposis, germline testing and family surveillance | draft |
| screening-and-early-detection.md | FIT, colonoscopy, stool DNA, blood tests, age, intervals and participation | draft |
| localized-colon-cancer.md | Surgery, nodal harvest, stage II risk, adjuvant and neoadjuvant therapy | draft |
| localized-rectal-cancer.md | MRI staging, TNT, surgery, radiation and organ preservation | draft |
| metastatic-systemic-therapy.md | Cytotoxic backbones, biologics, sequencing and maintenance | draft |
| precision-oncology.md | RAS, BRAF, HER2, MSI, NTRK, KRAS G12C and resistance | draft |
| liver-and-lung-metastasis.md | Resectability, ablation, conversion therapy and recurrence | draft |
| survivorship-and-late-effects.md | Bowel, sexual and urinary function, neuropathy, stoma and surveillance | curated |
| guidelines.md | Screening, staging, treatment, surveillance and guideline disagreement | draft |
| biomarkers-and-liquid-biopsy.md | CEA, tissue markers, ctDNA and molecular residual disease | draft |
| clinical-trials-landscape.md | Perioperative, organ-preservation, targeted and immune trials | draft |
| patient-experience-and-advocacy.md | Screening barriers, stoma, treatment burden, inequity and organizations | curated |
| red-flags-and-safety-concerns.md | Obstruction, perforation, bleeding, sepsis and treatment toxicity | draft |
Literature layer¶
| Artifact | Contents | Build state |
|---|---|---|
| BIBLIOGRAPHY.md | 345 unique PubMed papers; 14 added in the 2026-10-26 sweep with retraction checks | pending independent audit |
| Landmark notes | Six structured notes: adenoma–carcinoma sequence, CMS, MOSAIC, KEYNOTE-177, DYNAMIC and OPRA | complete |
| Guideline registry | 39 documents, supersession chains, disagreements and watch list | complete |
| Statistics sourcebook | Source/year/population/method ledger of burden, screening, treatment, biomarker and survivorship estimates | complete |
| Patient-voice README | Method, ethics, update rules and scope | complete |
| Patient organizations | Ten organizations verified from their own public sites | complete |
| Patient-experience themes | Twelve themes, each supported by at least two independent sources | complete |
| Patient-voice sources | Annotated PubMed and organization sources with coverage limits | complete |
| OPEN-QUESTIONS.md | 31 stable-ID questions in two tiers plus 12 cross-domain junctions | complete |
Curation state¶
This condition received a full build on 2026-08-29 and a separate audit on 2026-08-30. The audit re-fetched every cited PMID and NCT record, reconciled claim and reference metadata, corrected quantitative and overstatement errors, refreshed evidence-gap searches, and verified all external literature-layer URLs. All 18 pages passed that audit. The 2026-10-12 sweep revised five pages. The 2026-10-19 sweep revised eleven wiki pages, added 16 bibliography records and five guideline records, and left those pages in draft for a different engine to audit. The 2026-10-26 sweep revised five wiki pages (localized colon, localized rectal, metastatic systemic therapy, precision oncology, clinical-trials landscape; localized colon newly demoted from curated) and added 14 bibliography records and one guideline record. Query strings and identifiers are in literature/sweeps/2026-10-19.json and literature/sweeps/2026-10-26.json. The earlier roadmap state was audited; the maintenance changes are pending review.