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The microbial landscape of colorectal cancer

Nature Reviews Microbiology volume 22, pages 240–254 (2024)Cite this article

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Abstract

Colorectal cancer (CRC) is a substantial source of global morbidity and mortality in dire need of improved prevention and treatment strategies. As our understanding of CRC grows, it is becoming increasingly evident that the gut microbiota, consisting of trillions of microorganisms in direct interface with the colon, plays a substantial role in CRC development and progression. Understanding the roles that individual microorganisms and complex microbial communities play in CRC pathogenesis, along with their attendant mechanisms, will help yield novel preventive and therapeutic interventions for CRC. In this Review, we discuss recent evidence concerning global perturbations of the gut microbiota in CRC, associations of specific microorganisms with CRC, the underlying mechanisms by which microorganisms potentially drive CRC development and the roles of complex microbial communities in CRC pathogenesis. While our understanding of the relationship between the microbiota and CRC has improved in recent years, our findings highlight substantial gaps in current research that need to be filled before this knowledge can be used to the benefit of patients.

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Fig. 1: Associations between specific microorganisms and CRC.
Fig. 2: Microbial mechanisms of CRC pathogenesis.
Fig. 3: Microbial communities and CRC pathogenesis.

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Acknowledgements

This work was funded by the US National Institutes of Health (R01CA196845 and U2CCA233291), Cancer Research UK (Cancer Grand Challenges OPTIMISTICC team grant A27140) and Janssen. The authors are grateful for the contributions of members of the Sears Laboratory over time.

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  1. Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Maxwell T. White & Cynthia L. Sears

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The authors contributed equally to the design of the manuscript. M.T.W. wrote most of the manuscript and created all display items. C.L.S. wrote the Conclusions and clinical applications section and edited the manuscript.

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Correspondence to Cynthia L. Sears.

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The Sears Laboratory receives research support through Johns Hopkins University School of Medicine from Janssen and Bristol Myers Squibb.

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White, M.T., Sears, C.L. The microbial landscape of colorectal cancer. Nat Rev Microbiol 22, 240–254 (2024). https://doi.org/10.1038/s41579-023-00973-4

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