: The increasing incidence of colorectal cancer (CRC) in young adults warrants early and preferably non-invasive diagnostic modalities. Although the current stool-based assays have had good performance indicators for CRC detection, the overall poor uptake remains a challenging issue. However, alternative blood and urine markers are emerging.: This paper discusses the various urinary biomarkers available for the detection of CRC. The more commonly encountered drawbacks are the small number of studies and size of the study population. We discuss the role of microRNA and ProstaglandinE2 in CRC detection. The emergence of new, low cost technologies, specifically in the detection of volatile organic compounds (VOCs), present a promising future. We postulate possible mechanisms for the origin of these VOCs in urine and their role in carcinogenesis.: Urinary biomarkers provide an alternative option to the stool-based screening tests. MicroRNA and ProstaglandinE2 have shown utility in CRC detection. Evidence so far suggests that VOCs could also be a potential biomarker for the detection of CRC. In addition to its interaction within the colon lumen, this altered ‘VOC signature’ might also play a role in carcinogenesis. Low cost technology may enable such diagnostic methods to be utilized at point of care.
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