en Gastroenterology Gastroenterology Meta-analysis Article <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><b>&nbsp;&nbsp;</b><b><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp; Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">Gastrointestinal (GI) cancers remain a leading cause of cancer-related mortality worldwide, underscoring the urgent need for reliable, non-invasive diagnostic biomarkers. Circular RNAs (circRNAs), characterized by high stability and tissue specificity, have emerged as promising molecular indicators for early cancer detection. This study aimed to evaluate the diagnostic accuracy of circular RNAs (circRNAs) for detecting gastrointestinal (GI) cancers, including gastric cancer (GC), hepatocellular carcinoma (HCC), esophageal cancer (EC), colorectal cancer (CRC), and pancreatic cancer (PC).</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> A comprehensive literature search was conducted in PubMed, Web of Science, Scopus, and EMBASE up to December 2024, following PRISMA guidelines. Quality assessment was performed using the QUADAS-2 tool. Diagnostic accuracy metrics were analyzed using Metandi and Midas modules in STATA 17.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results: </b>From 9,733 retrieved articles, 139 studies involving 25,847 participants and 153 circRNAs met inclusion/exclusion criteria. No new eligible studies were identified from July 2021 to December 2024. The pooled diagnostic performance of circRNAs for gastrointestinal cancers was: sensitivity 0.78 (95% CI: 0.76&ndash;0.79), specificity 0.76 (95% CI: 0.74&ndash;0.77), PLR 3.3 (95% CI: 3.1&ndash;3.5), NLR 0.29 (95% CI: 0.27&ndash;0.31), and AUC 0.83 (95% CI: 0.80&ndash;0.85). Specific circRNAs (e.g., hsa_circ_0001017, circ-SLC7A5, circ-LDLRAD3) showed promising diagnostic performance.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion:</b> CircRNAs exhibit good diagnostic accuracy for hepatocellular carcinoma (AUC 0.83) and esophageal cancer (AUC 0.81), moderate-to-good accuracy for gastric cancer (AUC 0.79) and pancreatic cancer (AUC 0.78), but limited accuracy for colorectal cancer (AUC 0.68), highlighting their potential as non-invasive biomarkers, particularly for HCC and EC, with further validation needed to enhance clinical utility.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal"></span></span></span></span></span></span></span></span><br> &nbsp; Gastrointestinal cancers, circRNAs, Biomarkers, Diagnostic accuracy, Meta-analysis 1421 1436 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1741-27&slc_lang=en&sid=1 Jila Bahramirad zh_raad93@yahoo.com 200319475328460095647 200319475328460095647 No Department of Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran Yousef Moradi Yousefmoradi211@yahoo.com 200319475328460095648 200319475328460095648 No Health Metrics and Evaluation Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran Ghobad Moradi moradi_gh@yahoo.com 200319475328460095649 200319475328460095649 No Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Kurdistan, Iran Hojat Dehghanbanadaki dehghan.hojat@yahoo.com 200319475328460095650 200319475328460095650 No Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran Mohammad Abdi abdi355@gmail.com 200319475328460095651 200319475328460095651 No Department of Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran Sherko Nasseri sherko.naseri@yahoo.com 200319475328460095652 200319475328460095652 Yes Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran