The Correlation Between Fusobacterium nucleatum and Colorectal Cancer: A Comprehensive Review

Colorectal cancer (CRC) continues to be a significant health concern worldwide, and recent research has highlighted an intriguing association with Fusobacterium nucleatum. The prevalence of F. nucleatum in CRC tissues varies significantly across studies, with estimates ranging from 13% to 80%, complicating efforts to define the bacterium’s precise role in CRC development. Although the involvement of F. nucleatum in the initiation of CRC is still debated, there is a broad consensus regarding its role in cancer progression and metastasis. Elucidating the molecular mechanisms of F. nucleatum-mediated carcinogenesis could provide new avenues for managing CRC. F. nucleatum significantly facilitates the growth of CRC via its FadA adhesion. It attaches to E-cadherin (CDH1) and activates Wnt/β-catenin signaling. Consequently, inflammatory genes, Wnt-related genes, and oncogenes, such as c-Myc and Cyclin D1 (CCND1), are overexpressed. Various preventive and therapeutic strategies against F. nucleatum in CRC have been investigated, including the Fn-AhpC recombinant protein vaccine in mice and the use of metronidazole to reduce intratumoral bacterial load. Additionally, bacteriophages and nanoparticles are emerging as potential therapeutic tools. This review aims to provide a comprehensive overview of the role of F. nucleatum in CRC and to explore its potential as a target for novel therapeutic strategies.