Peer-Reviewed Publication
J Epidemiol Community Health2026;80(7):480-483.June 10, 2026Journal Article
Using wastewater for population-level colorectal cancer surveillance: a future research agenda.
Elizabeth Wurtzler1, Erica K Barnell1,2, Catherine Morrison1, Clayton Grass1, Natalie DuPré3, Donald J Biddle4, Allie Jin5, Sandy Kavalukas6, Rochelle H Holm7, Ted R Smith7
1Geneoscopy Inc, St. Louis, Missouri, USA.
2Department of Medicine, School of Medicine, Washington University, St. Louis, Missouri, USA.
3Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA.
4Department of Geographic and Environmental Sciences, Center for Geographic Information Sciences, University of Louisville, Louisville, Kentucky, USA.
5School of Medicine, University of Louisville, Louisville, Kentucky, USA.
6Hiram C. Polk Jr., M.D., Department of Surgery, School of Medicine, University of Louisville, Louisville, Kentucky, USA.
7Center for Healthy Air Water and Soil, Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, Kentucky, USA rochelle.holm@louisville.edu ted.smith@louisville.edu.
Abstract
BACKGROUND: Individual screening for colorectal cancer (CRC) is typically performed through either direct clinical examination, such as a colonoscopy, or an approved non-invasive test that measures CRC markers shed from the tumour into stool. There are known barriers to current screening recommendations.
METHODS: We present feasibility data demonstrating the detection of CRC-associated RNA biomar…
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