{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:03:10Z","timestamp":1787922190112,"version":"build-2784847793"},"reference-count":128,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>CRC remains a major cause of cancer-related morbidity and mortality worldwide. In recent years, the gut microbiota has gained increasing attention in CRC research. Intestinal microbes are not passive bystanders in tumor development. They may promote persistent inflammation, disrupt epithelial barrier integrity, alter microbial metabolites, and affect host immune and signaling pathways. Emerging evidence also suggests that microbiota-related metabolites and microbial functional alterations may influence host epigenetic regulation, including DNA methylation and chromatin-associated signaling, thereby further shaping colorectal carcinogenesis. Together, these changes can create a microenvironment that favors tumor initiation and progression. Several bacterial species, including Fusobacterium nucleatum, Parvimonas micra, and Peptostreptococcus anaerobius, have been repeatedly associated with CRC. In contrast, beneficial commensal microbes and their metabolites, especially short-chain fatty acids, may help maintain intestinal homeostasis and limit tumor-promoting processes. Because the gut microbiota is strongly shaped by diet, lifestyle, and environmental exposure, regional differences are also relevant. This is particularly important in Sichuan, China, where distinctive dietary habits and environmental features may influence microbial patterns associated with CRC risk and disease behavior. This review summarizes the main mechanisms linking the gut microbiota to CRC, examines the regional context of Sichuan, China, and discusses current and emerging clinical strategies. These include dietary intervention, probiotics, fecal microbiota transplantation, and microbiome-informed approaches to prevention, diagnosis, and treatment.<\/jats:p>","DOI":"10.3390\/cancers18111693","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T13:12:08Z","timestamp":1779455528000},"page":"1693","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gut Microbiota in Colorectal Cancer: Mechanistic Insights, Clinical Strategies, and a Regional Perspective with a Focus on Sichuan, China"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4280-0084","authenticated-orcid":false,"given":"Zuoliang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Maoyuan South Road, Shunqing District, Nanchong 637000, China"},{"name":"School of Graduate Studies, Post Graduate Centre, Management and Science University, Seksyen 13, Shah Alam 40100, Selangor, Malaysia"},{"name":"Institute of Hepatobiliary Pancreatic Intestinal Diseases, North Sichuan Medical College, Maoyuan South Road, Shunqing District, Nanchong 637000, China"},{"name":"National Clinical Key Specialty (General Surgery), Sub-Center of National Clinical Research Center for Digestive Diseases, Sichuan Clinical Research Center for Digestive Diseases, Maoyuan South Road, Shunqing District, Nanchong 637000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2709-6754","authenticated-orcid":false,"given":"Mia Yang","family":"Ang","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Allied Health Science, Faculty of Health and Life Sciences, Management and Science University (MSU), University Drive, Off Persiaran Olahraga, Section 13, Shah Alam 40100, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9793-5616","authenticated-orcid":false,"given":"Chin Siang","family":"Kue","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Allied Health Science, Faculty of Health and Life Sciences, Management and Science University (MSU), University Drive, Off Persiaran Olahraga, Section 13, Shah Alam 40100, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global Cancer Statistics 2022: Globocan Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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