# The presence and relative abundance of salivary Fusobacterium nucleatum are not associated with colorectal cancer: a systematic review and meta-analysis

## TL;DR

This study finds no link between the presence of a specific mouth bacteria and colorectal cancer, suggesting it may not be a useful non-invasive biomarker.

## Contribution

The study is the first to systematically review and meta-analyze salivary Fusobacterium nucleatum's association with colorectal cancer.

## Key findings

- Salivary Fusobacterium nucleatum presence does not significantly differ between colorectal cancer patients and controls.
- Relative abundance of salivary Fusobacterium nucleatum is not associated with colorectal cancer.
- Meta-analysis found no strong evidence supporting salivary Fusobacterium nucleatum as a biomarker for colorectal cancer.

## Abstract

Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related deaths. Early detection through non-invasive methods is critical for improving patient outcomes. This study investigates the association between the presence and relative abundance of Fusobacterium nucleatum (Fn) in saliva and CRC, evaluating its potential as a non-invasive biomarker. A systematic search was performed in MEDLINE, Embase, CENTRAL, and Scopus databases on November 25, 2023. Studies analyzing Fn in salivary samples from adults with CRC, colorectal polyps (CRP), or healthy individuals were included. Statistical analyses were performed using random-effects models to calculate pooled odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI). The risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. Of the 14,200 studies identified, twelve were included in our systematic review. Of these, eight were analyzed by meta-analysis. The results indicated no significant difference in the presence (OR 1.40; 95% CI [0.77; 2.54]; I2 = 0% [0; 71%], p = 0.215) or relative abundance (MD -0.01; 95% CI [-0.13; 0.11]; I2 = 25% [0; 69%], p = 0.851) of salivary Fn among CRC patients, compared to a combined group of CRP and healthy controls. Our findings suggest that the presence and relative abundance of salivary Fn are not associated with CRC.

The online version contains supplementary material available at 10.1038/s41598-025-07465-w.