Most sporadic CRCs ('adenoma-carcinoma' sequence) develop through multi-step and multi-genetic alterations. Recent advances in cancer pathogenesis help us in untangling the valid enzymatic and molecular biomarkers that are involved in colon tumorigenesis. The identification/discovery of these biomarkers ranges from exposure assessment, risk assessment and management to clinical trials. This is helpful for us to develop and discover novel therapeutic interventions, preventive strategies and chemopreventive agents. Along with these, there is also a need to develop and validate molecular biomarkers reflective of exposure and risk from etiological factors. [60-64] There are high-risk people who are most susceptible to chronic disease, including cancer. Hence, methods that identify such high-risk individuals will greatly facilitate the implementation of a spectrum of targeted prevention techniques directed to reducing individual risk. Currently developed technologies, -omics (genomics and proteomics) and miRNAs, are presently guiding the development of agents that are also able to target the biomarkers. Specific molecular processes have been targeted for therapeutic intervention, including growth factor receptors, proliferation signaling, cell cycling, apoptosis, angiogenesis, the immune system, etc. Most cancers are characterized by alternations in certain signaling pathways and identification of the aberrant pathway in cancer patients allows for targeted therapy to such specific pathways. The mechanism of CRC occurrence has been analyzed in detail. There are at least four carcinogenic pathways associated with colorectal oncogenesis, the 'adenoma-carcinoma' sequence type, 'de novo' type, HNPCC type and colitic cancer type.