Epigenetic disturbances in colorectal cancer

Colorectal cancer (CRC) is a major contributor to cancer-related death. A sequential accumulation of genetic alterations plays a central role in the development of the disease as described in the Vogelstein model of colorectal carcinogenesis. In the last two decades, however, it has become clear that CRC cells undergo major epigenetic alterations as well. Epigenetic dysregulation is organized at multiple levels and involves DNA methylation, histone modifications, chromatin looping, and noncoding RNAs. These modifications are associated with cancer initiation and progression and represent CRCs with clinically distinct prognosis and response to therapy. Here we outline the role of epigenetic processes in CRC carcinogenesis and the possibilities of applying epigenetic alterations as biomarker for early cancer detection and tailored treatment.