Two new studies published in Genome Research have made tentative steps towards establishing an infectious cause of colorectal cancer (CRC) by finding the periodontal pathogen Fusobacterium nucleatum in colon cancer tissue.

Around 18% of cancers worldwide are attributable to a known infectious agent—the unequivocal link between Helicobacter pylori and gastric cancer being a prime example. Given the huge numbers of micro-organisms in the colon, investigating the potential infectious agents that cause CRC seems reasonable.

Credit: Background image courtesy of CDC/V. R. Dowell Jr

In the first study, Matthew Meyerson and co-workers used next-generation, whole-genome sequencing to characterize the composition of the microbiota of CRC tumors. DNA sequences of Fusobacterium species were enriched in CRC tumors compared with control samples; nine CRC samples were initially studied, with an additional 95 CRC tumor samples analyzed to verify results. A number of Fusobacterium spp. sequences were discovered in the CRC tumors, with F. nucleatum being the most dominant phylotype identified. Finally, using fluorescence in situ hybridization, Fusobacterium could be detected in histological sections of CRC tumors.

Using a similar genomic approach, Robert Holt and colleagues used shotgun sequencing to mine CRC tumor and control tissue samples for microbial RNA sequences. F. nucleatum sequences were over-represented in CRC tumor samples, in both the initial 11 samples analyzed and in the additional 88 specimens tested, and overabundance of F. nucleatum sequences in CRC tumors was positively associated with lymph node metastasis. In addition, the researchers cultured an F. nucleatum isolate directly from a CRC tumor sample, which in vitro studies confirmed to be invasive in human colonic epithelial cells.

“The presence of a specific microbe with a strong preference for tumors was surprising,” notes Holt, and both research teams acknowledge that much work is needed to confirm whether F. nucleatum truly has a causative role in CRC etiology. “We don't know yet if Fusobacterium infection is causing colon cancer, is a consequence of colon cancer, or something in between,” warns Meyerson. However, if the causative link is proven, antibiotics and/or vaccines could be future treatment or prevention strategies to combat any infections that might cause CRC.