To ascertain the performance of gut-based biomarkers in colorectal cancer (CRC) diagnosis and investigate the impact of host characteristics on this performance.
Approach:
Systematic Review and Meta-Analysis: Conducted a systematic review and meta-analysis of 27 studies to evaluate the diagnostic performance of gut microbiome biomarkers for CRC.
Key Findings:
Average AUROC of 0.89 for differentiating CRC cases and 0.80 for adenoma cases.
Negative relationship between sample size and reported AUROC, suggesting potential overfitting.
Age difference between cases and controls was a significant moderator of diagnostic performance (p = 0.009).
Notable consistency in specific CRC-associated biomarkers, including enrichment of Fusobacterium nucleatum, Parvimonas micra, and Peptostreptococcus stomatis, and depletion of butyrate producers like Roseburia spp. and Faecalibacterium prausnitzii.
Interpretation:
The findings confirm the potential of gut microbiome-based biomarkers for CRC diagnosis, highlighting age as a critical confounder.
Limitations:
Heterogeneity in diagnostic performance across studies.
Potential overfitting due to small dataset sizes.
Conclusion:
The study emphasizes the need for incorporating host age in predictive models to enhance the generalizability and clinical translation of microbiome-based biomarkers for CRC diagnosis.
