By Joseph E. Scherger, MD, MPH
Core Faculty, Eisenhower Health Family Medicine Residency Program, Eisenhower Health Center, La Quinta, CA; Clinical Professor, Keck School of Medicine, University of Southern California, Los Angeles
SYNOPSIS: An E. coli variant found in the Western diet was associated with a higher incidence of colorectal cancer.
SOURCE: Arima K, Zhong R, Ugai T, et al. Western diet, polyketide synthase (pks) island-carrying Escherichia coli, and colorectal cancer: Analysis from two large prospective cohort studies. Gastroenterology 2022; Jun 24:S0016-5085(22)00672-2. doi: 10.1053/j.gastro.2022.06.054. [Online ahead of print].
Arima et al studied data about 121,700 women in the Nurse’s Health Study and 51,529 men in the Health Professionals Follow-Up Study. Specifically, they were searching for tissue markers in subjects who developed colorectal cancer (3,200 cases). Investigators found a disproportionate amount of pks+ Escherichia coli found in the Western-style diet, which often includes an overabundance of processed foods (along with red meat). While this diet has been associated with colorectal cancer, this is the first study associating this link with a bacteria in the gut microbiome.
COMMENTARY
The Western diet, with its processed foods and lack of fiber, leads to a microbiome lacking in many of the species our ancestral diet provided. This can lead to major health consequences, which researchers are discovering through microbiome science. Colorectal cancer is becoming increasingly common, especially in younger adults, such that screening guidelines have changed recently. Instead of starting at age 50 years, guidelines now suggest clinicians start screening patients for colorectal cancer at age 45 years.1-3 Rather than focusing only on screening and early detection of colorectal cancer, clinicians should be proactive by helping patients cultivate a healthy microbiome. Avoid this dreadful disease by eating healthy foods of nature.
REFERENCES
1. Loomans-Kropp HA, Umar A. Increasing incidence of colorectal cancer in young adults. J Cancer Epidemiol 2019;2019:9841295.
2. American Cancer Society. Colorectal cancer early detection, diagnosis, and staging. Last revised June 29, 2020.
3. U.S. Preventive Services Task Force. Colorectal cancer: Screening. May 18, 2021.
An E. coli variant found in the Western diet was associated with a higher incidence of colorectal cancer.
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