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Over the past 10 years, the incidence and mortality of colorectal cancer (CRC) in the USA has steadily declined. However, this fall has been less dramatic among African-Americans (AA), who continue to have the highest rates of mortality from CRC when compared with other ethnic subgroups.1 The reasons for the health disparities are multifactorial and represent socioeconomic factors and barriers to effective screening. The gut microbiome is increasingly implicated as a critical cometabolic engine that mediates the impact of environmental modifiers such as diet in high-risk cohorts.2 Despite the emergence of several theories for the role of the gut microbiome in colon cancer initiation, a precise mechanism has yet to be definitively elucidated.3 ,4 A major challenge is deciphering the huge range of molecular signalling languages the microbiome uses to influence human health. The intestinal microbiota plays a central role in digestive biochemistry and element cycling, which has largely been under-reported in CRC studies.
The study by Yazici et al5 is important because it provides compelling evidence that the gut microbiome plays a significant part in defining cancer risk in AAs by modifying sulfur metabolism. Hydrogen sulfide (H2S) is a regulator of gut health linked with multiple GI diseases, and …
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Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.