The Crucial Roles of Diet, Microbiota, and Postbiotics in Colorectal Cancer - Accepted and Published Online in 2024

Sep 21, 2026

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Colorectal cancer ranks among the world’s most lethal cancers, with rising prevalence in recent years. After dysbiosis was identified in colorectal cancer, research shifted from probiotics toward non-living cells, components, and metabolites due to safety concerns in susceptible and immunocompromised patients and risks such as antibiotic resistance. This review evaluates evidence on how diet, gut microbiota, and postbiotics influence colorectal cancer, and outlines directions for future postbiotics research.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages26

Reading Time1 h 6 min

AccessFree to download

Introduction

Epidemiology and burden of colorectal cancer

Genetic and epigenetic pathways

Dysbiosis and dietary modulation

Postbiotics in prevention and treatment

Mechanistic effects and clinical evidence

Cellular effects (apoptosis, proliferation, invasion)

Immune modulation and pathway suppression

Safety concerns and research gaps

Future directions

Current Nutrition Reports (2024) 13:126–151 [https://doi.org/10.1007/s13668-024-00525-z](https://doi.org/10.1007/s13668-024-00525-z) The Crucial Roles of Diet, Microbiota, and Postbiotics in Colorectal Cancer Rüya Kuru‑Yaşar1 · Özlem Üstün‑Aytekin1 Accepted: 25 February 2024 / Published online: 14 March 2024 © The Author(s) 2024 Abstract Purpose of Review Colorectal cancer is the second deadliest cancer in the world, and its prevalence has been increasing alarmingly in recent years. After researchers discovered the existence of dysbiosis in colorectal cancer, they considered the use of probiotics in the treatment of colorectal cancer. However, for various reasons, including the low safety profile of probiotics in susceptible and immunocompromised patient5s, and the risk of developing antibiotic resistance, researchers have shifted their focus to non-living cells, their components, and metabolites. This review aims to comprehensively evaluate the literature on the effects of diet, microbiota, and postbiotics on colorectal cancer and the future of postbiotics. Recent Findings The link between diet, gut microbiota, and colorectal cancer has been established primarily as a relationship rather than a cause-effect relationship. The gut microbiota can convert gastrointestinal tract and dietary factors into either onco-metabolites or tumor suppressor metabolites. There is serious dysbiosis in the microbiota in colorectal cancer. Postbiotics appear to be promising agents in the prevention and treatment of colorectal cancer. Summary It has been shown that various postbiotics can selectively induce apoptosis in CRC, inhibit cell proliferation, growth, invasion, and migration, modulate the immune system, suppress carcinogenic signaling pathways, maintain intestinal epithelial integrity, and have a synergistic effect with chemotherapy drugs. However, it is also reported that some postbiotics are ineffective and may be risky in terms of safety profile in some patients. Many issues need to be researched about postbiotics. Large-scale, randomized, double-blind clinical studies are needed. Keywords Diet · Microbiota · Dysbiosis · Postbiotics · Colorectal cancer Abbreviations 5-FU 5-Fluorouracil AKT A serine/threonine protein kinase AOM Azoxymethane APC Adenomatous polyposis coli BAD BCL2-associated agonist of cell death BAK Bcl-2 homologous antagonist/killer BAX Bcl-2-associated X protein Bcl-xl B-cell lymphoma-extra-large Bcl-2 B-cell lymphoma 2 CFS Cell-free supernatant CIMP CpG island methylator phenotype CIN Chromosomal instability CRC Colorectal cancer * Özlem Üstün-Aytekin [ozlem.aytekin@sbu.edu.tr](ozlem.aytekin@sbu.edu.tr) 1 Department of Nutrition and Dietetics, Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668 Istanbul, Türkiye DCC DSS EPS GLUT-1 HDAC IL MSI ISAPP SMAD2 K-ras MAPKMyD88 NADPH NF-κB NLRP3 OTUs PARP Deleted in colorectal cancer Dextran sodium sulfate Exopolysaccharides Glucose transporter-1 Histone deacetylase Interleukin Microsatellite instability International Scientific Association for Probiotics and Prebiotics Mothers Against Decapentaplegic homolog 2 Kirsten rat sarcoma virus Mitogen-activated protein kinase Myeloid differentiation primary response protein 88 Nicotinamide adenine dinucleotide phosphate Nuclear factor kappa B Nucleotide-binding-domain-and leucine-rich repeat-containing family, pyrin-domaincontaining 3 Operational taxonomic units Poly ADP ribose polymerase PI3K Phosphatidylinositol 3-kinase RAS Rat sarcoma virus ROS Reactive oxygen species SCFAs Short-chain fatty acids S-layers Surface layers SMO Smoothened TMAO Trimethylamine-N-oxide TLR-4 Toll-like receptor-4 TNF-α Tumor necrosis factor alpha Wnt Wingless-related integration site Introduction Colorectal cancer (CRC), which includes cancers that occur in the colon and rectum, is the third most common type of cancer in onc

FAQs

Why has research moved from probiotics to postbiotics for colorectal cancer?

Probiotics raise safety concerns in susceptible and immunocompromised patients and may contribute to antibiotic resistance. The review discusses a shift toward non-living cells, their components, and metabolites, collectively captured by the postbiotic concept.

What does the review say about the relationship between diet, gut microbiota, and colorectal cancer?

The link is established primarily as an association rather than a clear cause-effect relationship. Gut microbiota can transform gastrointestinal and dietary factors into tumor-suppressing or onco-metabolites.

What benefits and limitations of postbiotics are highlighted?

Postbiotics may induce apoptosis in CRC, inhibit proliferation, affect invasion and migration, modulate immunity, suppress carcinogenic signaling, and support intestinal epithelial integrity, including synergy with chemotherapy. At the same time, some postbiotics can be ineffective and may carry safety risks in certain patients.

Sep 21, 2026

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