Abstract

Colorectal cancer (CRC) remains a leading cause of cancer morbidity and mortality worldwide, with early 
detection critical to improving outcomes. Liquid biopsy genomics offers a minimally invasive approach to detect 
tumor-derived analytes in biofluids, providing insights into tumor burden, genomic alterations, and treatment 
response. Precision public health applications of liquid biopsy enable population-level risk stratification, 
integration of genomic, clinical, and sociodemographic data, and targeted interventions for early-stage CRC 
detection. Evidence indicates that liquid biopsy can enhance screening accessibility, particularly in underserved 
populations, while supporting real-time monitoring of therapeutic response and disease recurrence. However, 
challenges persist in implementation, including data integration, health system logistics, workforce capacity, 
regulatory frameworks, and equity considerations. Addressing these barriers is essential for translating liquid 
biopsy genomics into actionable population-level CRC interventions.