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INTERNATIONAL CONGRESS OF

CancerGenetics

• Dietary Fiber and Gut Microbiota in Colorectal Cancer: A Narrative Review

• Parvin Babaei ,¹ Vajihe Ghalenoei ,² Vahideh Hejininezhad,³ Mahsa Karimzadeh ,⁴ Hiva Azami ,^5,*
  1. MSc Pediatric Nursing Student, Student Research Committee, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  2. BSc in Nursing, Faculty of Medical Sciences, Islamic Azad University of Birjand, South Khorasan, Iran
  3. Student Research Committee, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  4. Student Research Committee, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  5. Department of Medical Emergencies, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
  
  
  
• Introduction: Colorectal cancer (CRC), as one of the most common causes of cancer-related deaths worldwide, poses a significant public health challenge. Several factors, including poor dietary habits and a sedentary lifestyle, are associated with an increased risk of this disease. In recent years, the vital role of the gut microbiota and dietary fibers in the pathogenesis and prevention of CRC has become increasingly prominent. This review aims to provide a comprehensive overview of the existing evidence regarding the role of dietary fiber and the gut microbiota in the incidence, progression, and treatment response of this disease.
• Methods: In this narrative review, a comprehensive search was conducted using Boolean operators (AND/OR) and a combination of MeSH and non-MeSH keywords. The main search keywords, in both English and Persian, were: colorectal cancer, dietary fiber, gut microbiome, short-chain fatty acids, and pectin. The search was performed in international databases including PubMed, Scopus, Web of Science, and the Google Scholar search engine, as well as national databases such as SID and Magiran. The initial search yielded 98 studies. Inclusion criteria included original research articles and review articles on the topic in humans and animal models, published within the last 5 years (2020 to 2025), in either Persian or English, with open access to the full text. Exclusion criteria included irrelevant studies, letters to the editor, and duplicate items. After removing duplicates and ensuring alignment with the study's objective, a final number of 10 studies were selected for analysis and review.
• Results: The results of this study showed that dietary fibers play a crucial protective role against CRC, and insufficient intake is associated with an increased risk of the disease. These effects are partly mediated by modulating the gut microbiota. Changes in the gut microbiota composition (dysbiosis) are common in CRC patients and are associated with disease progression, inflammation, and treatment response. Dietary fibers, especially pectin, when fermented by the gut microbiome, increase the production of short-chain fatty acids (SCFAs) such as butyrate. Butyrate has anti-cancer properties, including inducing apoptosis, reducing cell proliferation, and modulating the immune response. Furthermore, evidence suggests that the gut microbiome and dietary fibers can influence the effectiveness of immunotherapy (such as PD-1 inhibitors) in CRC, and supplements like pectin are capable of enhancing the treatment response.
• Conclusion: This narrative review demonstrates that dietary fibers and the gut microbiota play a vital role in the prevention, progression, and treatment response of colorectal cancer through multiple mechanisms, such as producing SCFAs and modulating the immune system. The results of this review are consistent with similar research that addresses the role of nutrition and the microbiome in cancer control. However, the majority of the available evidence comes from preclinical studies (animal and laboratory models), which limits its direct generalizability to humans. The practical applications of these findings could include providing a basis for developing complementary nutritional strategies or using fiber-derived compounds as new therapeutic approaches for CRC patients. To definitively confirm these effects and determine their efficacy and safety in humans, it is recommended that future research conduct well-designed clinical trials with large sample sizes.
• Keywords: Colorectal cancer, Dietary fiber, Gut microbiota, Short-chain fatty acids, Pectin