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A systematic review of microbiome-derived biomarkers for early colorectal cancer detection

Journal

NEOPLASIA
Volume 36, Issue -, Pages -

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.neo.2022.100868

Keywords

Colorectal cancer; Screening; Biomarker; Microbiome; Metabolomics

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Increasing evidence suggests that the gut microbiome may play a role in colorectal cancer development and can be used as a biomarker for early detection. This review provides an overview of published studies on the use of the microbiome as a screening tool for early colorectal cancer. A total of 28 studies were included, showing varying diagnostic performance of fecal bacteria-derived and co-metabolome-derived biomarkers. The findings suggest the potential of the gut microbiome as a complement to existing screening tools, but further research is needed before clinical implementation.
Increasing evidence suggests a role of the gut microbiome in the development of colorectal cancer (CRC) and that it can serve as a biomarker for early diagnosis. This review aims to give an overview of the current status of published studies regarding the microbiome as a screening tool for early CRC detection. A literature search was conducted using PubMed and EMBASE in August 2022. Studies assessing the efficacy of microbiome-derived biomarkers based on noninvasive derived samples were included. Not relevant studies or studies not specifying the stage of CRC or grouping them together in the analysis were excluded. The risk of bias for screening tools was performed using the QUADAS-2 checklist. A total of 28 studies were included, ranging from 2 to 462 for CRC and 18 to 665 advanced adenoma patient inclusions, of which only two investigated the co-metabolome as biomarker. The diagnostic performance of faecal bacteria-derived biomarkers had an AUC ranging from 0.28-0.98 for precursor lesions such as advanced adenomas and 0.54-0.89 for early CRC. Diagnostic performance based on the co-metabolome showed an AUC ranging from 0.69 - 0.84 for precursor lesions and 0.65 - 0.93 for early CRC. All models improved when combined with established clinical early detection markers such as gFOBT. A high level of heterogeneity was seen in the number of inclusions and methodology used in the studies. The faecal and oral gut microbiome has the potential to complement existing CRC screening tools, however current evidence suggests that this is not yet ready for routine clinical use.

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