Serum ferritin as a potential biomarker for distinguishing advanced-stage colorectal cancer: a retrospective cohort study

Background: Colorectal cancer (CRC) stage plays a major role in treatment decisions and prognosis. This study investigates whether Serum Ferritin can improve CRC staging and compares its performance to standard markers like carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA). Methods: We analyzed data from 419 CRC patients at Jiujiang College Affiliated Hospital, dividing them into early-stage (I-II, 245 patients) and late-stage (III-IV, 174 patients) groups. Logistic regression and receiver operating characteristic (ROC) curves were used to assess the usefulness of serum ferritin compared with traditional markers. Results: < 0.001). ROC analysis showed Serum Ferritin had a numerically higher area under the curve (AUC) (0.795) compared to CA 19-9 (0.745) and CEA (0.744) at distinguishing between early and advanced stages. The combined model yielded an AUC of 0.890. Conclusion: Serum Ferritin could be a useful addition to CRC staging, showing a numerically higher AUC than current markers. Adding it to clinical practice may help refine stage assessment and guide treatment decisions. This study supports its potential as a supplementary tool for stage assessment in CRC management.