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The colonic microbiome differs in colorectal cancer (CRC) patients. Specific bacteria like Fusobacterium and oral flora are linked to CRC, particularly through the serrated pathway, impacting prevention and treatment.

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Area of Science:

  • Gastroenterology
  • Microbiology
  • Oncology

Background:

  • Colorectal cancer (CRC) is a leading cause of cancer death, with rising incidence in young adults.
  • The colonic microbiome composition differs between CRC patients and healthy individuals.
  • Limited research explores the microbiome's role in distinct CRC carcinogenesis pathways (serrated vs. adenoma-carcinoma).

Purpose of the Study:

  • To address limitations in current CRC microbiome research.
  • To investigate the microbiome's contribution to CRC development via the serrated pathway and adenoma-carcinoma sequence.
  • To inform novel prevention, screening, and therapeutic strategies for CRC.

Main Methods:

  • Review of select human studies investigating the microbiome in CRC carcinogenesis.
  • Focus on studies using mucosal samples and comparing polyps/tumors by histopathology, molecular type, or location.
  • Analysis of findings related to the adenoma-carcinoma sequence and serrated pathway.

Main Results:

  • Fusobacterium is associated with right-sided, advanced, and serrated CRC lesions.
  • CRC patients' colons harbor bacteria typically found in oral flora.
  • Increased prevalence and proximal colon location of biofilms in CRC patients were noted in one study.

Conclusions:

  • Understanding the microbiome's role in distinct CRC pathways is crucial for advancing research.
  • Tailored interventions for CRC prevention, screening, and treatment can be developed by considering pathway-specific microbial influences.
  • Further research is needed to fully elucidate the complex interplay between the microbiome and CRC carcinogenesis.