Gut microbiome signatures in colorectal neoplasia: a cross-sectional study across neoplasia stages and subtypes.

Gut microbiome signatures are weakly associated with colorectal neoplasia and do not serve as robust early biomarkers in a large cross-sectional study.

• Why it matters: Identifying microbial markers for early detection of colorectal neoplasia could improve screening and prevention strategies, but current evidence on their predictive value remains inconclusive.
• What they did: The study analyzed stool metagenomes from 1762 participants undergoing colonoscopy, using statistical models and machine learning to assess associations between microbiome features and neoplasia presence, severity, and subtype.
• The result: Microbial differences between individuals with and without neoplasia were minimal, with associations attenuated after adjusting for covariates, and predictive models only modestly improved classification accuracy (AUC=0.64 vs 0.58), indicating limited diagnostic potential.