Gut Microbiota in Colorectal Cancer: Mechanisms of Carcinogenesis, Biomarkers, and Therapeutic Perspectives.

Authors

Bianca Andreea Cristinescu, Horatiu Dura, Sorin Radu Fleaca, Danusia Maria Onisor, Olga Brusnic, Corina Porr, Sabrina Birsan, Adrian Boicean

Published in

Journal of clinical medicine. Volume 15. Issue 14. Jul 08, 2026. Epub Jul 08, 2026.

Abstract

Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide, largely due to late-stage diagnosis and the limited sensitivity of current screening approaches for early lesions. In recent years, the gut microbiota has emerged as a key factor in colorectal carcinogenesis, offering promising opportunities for the development of novel, non-invasive diagnostic and therapeutic strategies. Specific bacterial species and microbial metabolites have been implicated in colorectal carcinogenesis and are under investigation as potential biomarkers for CRC detection. However, despite growing evidence of association, most remain investigational and require further clinical validation before routine implementation. Among the proposed bacterial biomarkers, Fusobacterium nucleatum is one of the most promising candidates for clinical implementation, with encouraging evidence supporting its use in non-invasive stool-based CRC detection. Streptococcus gallolyticus subsp. gallolyticus and Clostridium septicum currently serve primarily as clinical warning markers due to their well-established association with occult colorectal malignancy rather than as screening biomarkers. In contrast, pks⁺Escherichia coli, enterotoxigenic Bacteroides fragilis, Enterococcus faecalis, and Peptostreptococcus anaerobius remain investigational. Helicobacter pylori has limited value for CRC detection because of its inconsistent association and low specificity. Overall, this review summarizes the most extensively studied bacterial species and microbial metabolites involved in colorectal cancer development, with particular emphasis on their underlying pathogenic mechanisms and highlighting their potential value as diagnostic biomarkers and therapeutic targets. It also highlights emerging bacterial taxa and microbial signatures that have been associated with early tumorigenesis in recent studies.

PMID:
42513245
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.