Efficacy and Safety of Probiotics, Prebiotics and Synbiotics for the Prevention of Colorectal Cancer and Precancerous Lesion in High‐risk Populations: A Systematic Review and Meta‐analysis of Randomized Controlled Trials

Abstract

AbstractAimColorectal cancer is highly prevalent worldwide and is a leading cause of cancer‐related deaths. Probiotics, prebiotics, and synbiotics have recently garnered attention as preventive measures against colorectal neoplasms. We aimed to analyze and summarize the findings of randomized controlled trials that investigated the effects of probiotics, prebiotics and synbiotics on patients at high risk of colorectal cancer, specifically, outlining the challenges and future prospects of using probiotics to prevent colorectal tumors and providing evidence for clinical physicians.MethodsPubMed, Embase, and Cochrane Library was searched for relevant studies published before January 7, 2022. Our study selection criteria focused on randomized controlled trials conducted on populations with high risk of colorectal cancer that received probiotics and/or prebiotics and compared them with placebo or another candidate agent. The primary efficacy outcome was the incidence or recurrence of any colorectal neoplasms. Additional efficacy outcomes included the effects on the diversity of gut microbiota and relevant inflammatory biomarkers. Safety outcomes were also included. Two authors independently screened and selected studies based on prespecified inclusion. They also performed data extraction and risk‐of‐bias assessment independently.ResultsNine randomized controlled trials met our inclusion criteria. Probiotics supplementation significantly reduced adenoma incidence, but no significant difference was observed in colorectal cancer incidence. Additionally, probiotics modulated the gut microbiota and inflammatory factors.ConclusionsProbiotics may have beneficial effects in colorectal cancer prevention, particularly in the adenoma stage. However, more clinical trials with larger sample sizes are required to confirm these findings.This article is protected by copyright. All rights reserved.