The Relationship Between pks+ Escherichia coli and Colorectal Cancer: A Review

Introduction: According to GLOBOCAN estimates, colorectal cancer (CRC) was the third most common cancer worldwide in 2020, comprising 11% of all cancer diagnoses. Researchers’ interest in CRC development has shifted toward the gastrointestinal microbiome, especially the mutagenicity of pks+ E. coli. Therefore, we aimed to review the current evidence on the relationship between pks+ E. coli and CRC. Method: We reviewed the literature reporting the association between pks+ E. coli and CRC, which was obtained from three databases: PubMed, Google Scholar, and the Cochrane Library, published between January 2021 and January 2026. We used the following keywords for our search strategy: pks, Escherichia coli, and colorectal cancer. Result: As stated in the original studies, the contribution of pks+ E. coli to CRC development was associated with a higher prevalence in the CRC group than in the healthy group. However, these results are inconsistent across the studies. Conclusion: Given the limited evidence, researchers should conduct larger cohort studies to clarify this relationship and identify other factors contributing to the presence of pks+ E. coli, particularly across diverse clinical settings. Furthermore, clinical translation, such as the utilization of screening or therapeutic biomarkers, requires prospective validation and standardized detection methods.