Published online Sep 26, 2016. doi: 10.4252/wjsc.v8.i9.279
Peer-review started: May 27, 2016
First decision: June 17, 2016
Revised: July 12, 2016
Accepted: July 20, 2016
Article in press: July 22, 2016
Published online: September 26, 2016
Processing time: 115 Days and 11.9 Hours
Over the past two decades there has been remarkable progress in cancer diagnosis, treatment and screening. The basic mechanisms leading to pathogenesis of various types of cancers are also understood better and some patients, if diagnosed at a particular stage go on to lead a normal pre-diagnosis life. Despite these achievements, racial disparity in some cancers remains a mystery. The higher incidence, aggressiveness and mortality of breast, prostate and colorectal cancers (CRCs) in African-Americans as compared to Caucasian-Americans are now well documented. The polyp-carcinoma sequence in CRC and easy access to colonic epithelia or colonic epithelial cells through colonoscopy/colonic effluent provides the opportunity to study colonic stem cells early in course of natural history of the disease. With the advent of metagenomic sequencing, uncultivable organisms can now be identified in stool and their numbers correlated with the effects on colonic epithelia. It would be expected that these techniques would revolutionize our understanding of the racial disparity in CRC and pave a way for the same in other cancers as well. Unfortunately, this has not happened. Our understanding of the underlying factors responsible in African-Americans for higher incidence and mortality from colorectal carcinoma remains minimal. In this review, we aim to summarize the available data on role of microbiome and cancer stem cells in racial disparity in CRC. This will provide a platform for further research on this topic.
Core tip: The role of microbial dysbiosis and cancer stem cells (CSCs) in colorectal cancer (CRC) has been studied extensively, however, their implication in racial disparity is not well known. A number of recent studies have shown that different dietary patterns affect gut microbiome. Likewise, dietary patterns also affect intracellular regulatory events which may affect the function of CSCs. Our objective is to consolidate the available data, on the role of gut microbiome and CSCs in racial disparity in CRC, explore a link between them and lay a foundation for further advances.