A Review of Susceptibility Factors for Colibactin-Associated Colorectal Cancer in African Populations.

Colorectal cancer (CRC) is a significant public health concern in Africa. The rising incidence has been attributed to dietary and lifestyle modifications. Gut microbiota, particularly the bacterium Escherichia coli and its colibactin toxin, have been implicated in the development of CRC. Due to their ability to induce genomic instability and DNA damage in colonic epithelial cells, colibactin-producing E. coli strains have been linked to CRC. Determining high-risk individuals and creating focused prevention and treatment plans requires an understanding of the genetic susceptibility to colibactin-induced colorectal cancer among African communities. A scoping review was conducted aimed at synthesizing current knowledge on the mutagenic properties of polyketide synthase-positive E. coli (pks+ E. coli) and exploring genomic landscape and population-specific factors that may increase CRC susceptibility in African communities. This review found that African populations' genetic vulnerability to colibactin-induced CRC exhibits different genetic profiles than those of European populations, as the Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) and Wingless-related Integration Site (WNT) signaling pathway mutations are highly implicated among individuals of African descent. Additionally, other co-existing factors such as Lynch syndrome, Inflammatory bowel disease, parasitic infestation, and dietary changes influence the incidence rates of CRC among this population. Consequently, this information may help reduce the rising rate of CRC in African populations through lifestyle modification and chemotherapy choices. To fully understand the complex interactions among environmental variables, genetic vulnerability, and colibactin-induced colorectal carcinogenesis in African populations, further investigation is necessary.