Early Detection and Interception in Gastrointestinal Cancers—Endoscopic Imaging, Liquid Biopsy, and Validated Biomarkers

Gastrointestinal (GI) cancers—including pancreatic ductal adenocarcinoma (PDAC), hepatocellular carcinoma (HCC), cholangiocarcinoma, colorectal cancer, gastric cancer, and esophageal cancer—remain a major global health challenge. For many of these cancers, diagnosis at an advanced stage contributes to poor outcomes and limits curative treatment options.A primary driver of these high mortality rates is the "silent" nature of these diseases; most patients are diagnosed at advanced stages, when curative surgical resection is no longer viable. Despite significant advances in systemic therapies, long-term survival rates have not seen the transformative leaps observed in other oncological fields.The frontier of GI oncology is shifting toward early detection and interception. The goal is to identify pre-malignant lesions or early-stage carcinomas when they are most vulnerable to intervention. However, traditional screening methods often lack the sensitivity or specificity required for effective population-wide or high-risk surveillance. There is an urgent need to integrate next-generation diagnostic modalities—ranging from high-resolution endoscopic imaging to the molecular precision of liquid biopsies—into clinical workflows. By focusing on the biological "window of opportunity," we can move from reactive treatment to proactive prevention and early-stage cure.The primary objective of this Research Topic is to showcase cutting-edge research and clinical strategies aimed at improving the early diagnosis and "interception" of GI cancers, including HPB, colorectal, gastric, and esophageal cancers. We aim to bridge the gap between benchside molecular discovery and bedside clinical applications. Specifically, this collection seeks to:• Explore innovations that enhance the role of endoscopy in early GI neoplasia detection, including advances in imaging (e.g., contrast-enhanced and quantitative EUS), novel fluorescent and molecularly targeted probes for improved lesion characterization, and emerging approaches that integrate endoscopy with guided tissue and fluid sampling for biomarker-driven analyses—linking real-time visualization with molecular diagnostics to improve early diagnosis and risk stratification across HPB, colorectal, gastric, and esophageal cancers.• Explore the role of liquid biopsies (ctDNA, methylome analysis, exosomes), with particular attention to recent advances in ctDNA-based detection and integrated multi-omic biomarker strategies, as a non-invasive tool for surveillance and early detection.• Highlight the discovery and validation of novel cancer-specific biomarkers, including multi-omic signatures, with performance assessed against relevant current standards (such as CA 19-9 for pancreaticobiliary cancers and AFP for HCC).• Foster a multidisciplinary dialogue on how these tools can be integrated to create robust, personalized screening protocols for people at high risk of GI cancers.We invite original research articles, comprehensive reviews, and clinical trial protocols that address the technical and clinical challenges of early HPB cancer detection. We are particularly interested in submissions that utilize multi-omics approaches or artificial intelligence to enhance diagnostic accuracy. Themes of interest include, but are not limited to:• Advanced endoscopic and radiomic imaging for early tumor visualization.• Validation studies of blood, bile, or cyst-fluid-based biomarkers.• The application of AI and machine learning in identifying high-risk GI cancer cohorts.• Molecular interception strategies for pre-cancerous conditions (e.g., IPMNs, colorectal adenomas, gastric intestinal metaplasia, and Barrett’s esophagus).• Cost-effectiveness and implementation science regarding new screening modalities.Please note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo, which are not based on public databases) are not suitable for publication in this journal. Topic editors: ALESSANDRO MANNUCCI, Abdullah Esmail,MD Source: https://www.frontiersin.org/research-topics/86673/early-detection-and-interception-in-gastrointestinal-cancers-endoscopic-imaging-liquid-biopsy-and-validated-biomarkers