← Issue №4/ week of Jul 26, 2026/ the whole section, in full

Colorectal, in full.

All 3 Colorectal papers in this issue, as full cards, ranked by clinical utility. The issue page carries the strongest few; this is the section, whole.

Sections this issue
Filter

All 3, in full

most clinically useful first · the 1 the issue led with is ruled in green
Colorectal meta analysis · Jul 30, 2026 · J Gastroenterology · IF 5.7

Clinical applications of gut microbiome for non-invasive diagnosis of colorectal neoplasia.

Diagnosticmicrobiomebiomarkercolorectal cancercolorectal cancer screening
Clinical takeawayMicrobiome-based stool testing shows promise for improving adenoma detection in CRC screening, particularly for early-stage lesions missed by FIT alone. However, further validation and integration into screening programs are needed before clinical adoption.
What it foundA microbial panel (Fusobacterium nucleatum, Hungatella hathewayi, Christensenella hongkongensis, and m3 gene) demonstrated improved sensitivity for adenoma detection compared to FIT alone, with comparable accuracy for CRC.
ContextCurrent stool-based tests like FIT have limited sensitivity for adenoma detection. This study confirms microbial signatures as viable biomarkers and highlights their potential to enhance early CRC screening.
Measured against the standard of care· USMSTF 2017 (Rex et al., Gastroenterology) + USMSTF 2022 focused update on age (Patel et al., Gastroenterology 2022;162:285-299) / ACS 2026 (CA Cancer J Clin)

Decision at stakethe potential use of gut microbiome biomarkers for non-invasive colorectal cancer screening

… Multi-Society Task Force (2017 guideline, revised by the 2022 focused update on age to start and stop): offer average-risk colorectal cancer screening to everyone aged 45-75. … The American Cancer Society's May 2026 guideline agrees on the 45-75 range, no screening after 85, and colonoscopy as the preferred option. …

From our summary of this standard, unedited — the part the paper bears on. … marks omitted text. Our wording, not the guideline's; read the source for its own text.

Our full summary of this standard

U.S. Multi-Society Task Force (2017 guideline, revised by the 2022 focused update on age to start and stop): offer average-risk colorectal cancer screening to everyone aged 45-75. Screening at 45-49 is a weaker recommendation than at 50-75. Colonoscopy every 10 years and annual FIT are the Tier 1 cornerstones. Tier 2 alternatives are multi-target stool DNA every 3 years, CT colonography every 5 years, and flexible sigmoidoscopy every 5-10 years. Capsule colonoscopy every 5 years is Tier 3. Any abnormal non-colonoscopy test requires a diagnostic colonoscopy, and a stool test should not be offered to a patient who would decline follow-up colonoscopy. Patients who are up to date with negative prior screening, particularly a high-quality colonoscopy, may consider stopping at 75 or when life expectancy is under 10 years. Decisions at 76-85 are individualized by health and prior screening, and screening after 85 is not recommended. The American Cancer Society's May 2026 guideline agrees on the 45-75 range, no screening after 85, and colonoscopy as the preferred option. It adds the next-generation mt-sDNA test and the multitarget stool RNA test (ColoSense), both every 3 years, and it adds an FDA-approved blood-based cfDNA test (Shield) only for people who decline or do not complete visual or stool screening. ACS says a positive stool or blood test should be followed by colonoscopy, preferably within 6 months. The 2026 ASGE paper on follow-up after an abnormal stool test is an implementation review (navigation, tracking, direct-access colonoscopy), not a new screening guideline.

USMSTF 2017 (Rex et al., Gastroenterology) + USMSTF 2022 focused update on age (Patel et al., Gastroenterology 2022;162:285-299) / ACS 2026 (CA Cancer J Clin) · reviewed 2026-10-11 ↗
Cui C … Chan FKL · Journal of Gastroenterology · IF 5.7 · PubMed ↗Permalink
Colorectal prospective cohort · n=297 · Jul 27, 2026 · Am J Clin Nutrition · IF 6.5

One-carbon metabolism and chemotherapy-induced toxicities in patients with stage II-III colorectal cancer: a prospective cohort study.

New evidencecolorectal cancerbiomarker
Clinical takeawayNo clinical action yet: associations in a prospective cohort require validation in interventional trials before modifying nutrition or supplementation.
What it foundHigher folate (HR 0.75, 95% CI 0.57-0.98) and vitamin B2 (HR 0.81, 95% CI 0.67-0.99) were associated with lower capecitabine toxicity risk specifically in patients with MTHFR C677T CT/TT genotype, while higher glycine (HR 1.87, 95% CI 1.18-2.94) increased toxicity risk. Nonlinear associations were observed for vitamin B6 and vitamin B12.
ContextSuggests potential for personalized nutrition strategies to mitigate capecitabine toxicity in patients with MTHFR C677T CT/TT genotype, but current practice does not routinely adjust OCM biomarkers pre-chemotherapy.
Measured against the standard of care· USMSTF 2017 (Rex et al., Gastroenterology) + USMSTF 2022 focused update on age (Patel et al., Gastroenterology 2022;162:285-299) / ACS 2026 (CA Cancer J Clin)

Decision at stakeoptimizing chemotherapy tolerance in stage II-III colorectal cancer patients

… Multi-Society Task Force (2017 guideline, revised by the 2022 focused update on age to start and stop): offer average-risk colorectal cancer screening to everyone aged 45-75. …

From our summary of this standard, unedited — the part the paper bears on. … marks omitted text. Our wording, not the guideline's; read the source for its own text.

Our full summary of this standard

U.S. Multi-Society Task Force (2017 guideline, revised by the 2022 focused update on age to start and stop): offer average-risk colorectal cancer screening to everyone aged 45-75. Screening at 45-49 is a weaker recommendation than at 50-75. Colonoscopy every 10 years and annual FIT are the Tier 1 cornerstones. Tier 2 alternatives are multi-target stool DNA every 3 years, CT colonography every 5 years, and flexible sigmoidoscopy every 5-10 years. Capsule colonoscopy every 5 years is Tier 3. Any abnormal non-colonoscopy test requires a diagnostic colonoscopy, and a stool test should not be offered to a patient who would decline follow-up colonoscopy. Patients who are up to date with negative prior screening, particularly a high-quality colonoscopy, may consider stopping at 75 or when life expectancy is under 10 years. Decisions at 76-85 are individualized by health and prior screening, and screening after 85 is not recommended. The American Cancer Society's May 2026 guideline agrees on the 45-75 range, no screening after 85, and colonoscopy as the preferred option. It adds the next-generation mt-sDNA test and the multitarget stool RNA test (ColoSense), both every 3 years, and it adds an FDA-approved blood-based cfDNA test (Shield) only for people who decline or do not complete visual or stool screening. ACS says a positive stool or blood test should be followed by colonoscopy, preferably within 6 months. The 2026 ASGE paper on follow-up after an abnormal stool test is an implementation review (navigation, tracking, direct-access colonoscopy), not a new screening guideline.

USMSTF 2017 (Rex et al., Gastroenterology) + USMSTF 2022 focused update on age (Patel et al., Gastroenterology 2022;162:285-299) / ACS 2026 (CA Cancer J Clin) · reviewed 2026-10-11 ↗
Zwart NRK … Kok DE · American Journal of Clinical Nutrition · IF 6.5 · PubMed ↗Permalink
Colorectal retrospective · n=1,608 · Jul 28, 2026 · Gastroenterology · IF 25.1

AI-Assisted Risk Stratification in Stage II Colorectal Cancer: Multi-Institutional Validation of Semantically-Enhanced Deep Learning.

New evidenceartificial intelligencecolorectal cancerbiomarker
Clinical takeawayNo clinical action yet: validation of an AI tool for pathology slides. Consider future adoption if clinical trials confirm it improves adjuvant chemotherapy decisions in stage II CRC.
What it foundSÉMIL AI model stratified stage II CRC relapse risk (HR 1.98-4.73 across cohorts), outperforming non-semantic MIL (AUC 0.713-0.821 vs 0.686-0.803) and refining NCCN high-risk subgroup prognosis (HR 2.96-3.50).
ContextRefines but does not replace NCCN high-risk criteria (T4, MMR-D, etc.). First AI model to stratify within guideline-defined high-risk groups where treatment decisions are uncertain.
No standard claimed for this paper

Every paper is compared to the standard governing its question. This one is not: either no standard in the corpus matches it, or the comparison did not hold up on review and was withdrawn rather than published unverified. Both are logged.

Magisson F … Williams DS · Gastroenterology · IF 25.1 · PubMed ↗Permalink
← Back to issue №4 Every section of this issue is one click away, at the top of this page. Follow Colorectal by RSS