A Systematic Review: Role of Probiotics in Patients with

Colorectal Cancer

Rahma Adellia1, Iche Andriani Liberty2*

1. Medical Doctor Professional Study Program, Faculty of Medicine, Sriwijaya University,

Palembang, Indonesia
2. Department of Public Health and Community Medicine, Faculty of Medicine, Sriwijaya
University, Palembang, Indonesia

1. INTRODUCTION
Cancer is a leading cause of death worldwide. Colorectal cancer (CRC)
is one of very common cause death among patient with cancer. The symptoms
of CRC include unexplained anaemia, unexplained weight loss, bloating,
changes in the bowel movement habits, bloody stool, vomiting and pelvic
pain. Many study prove that CRC event is initiating of TP53 mutation
associated with colitis as well as mutation in sporadic CRC. The risk factors
for the development of CRC have been identified like genetic factor, age
factor and poor lifestyle habit. Moreover, CRC is also easily influenced by a
wide range of dietary factors, such as regular alcohol consumption, low fruit
and vegetable diet, low fiber and high-fat diet, or a diet high in processed
meats.
Patients with CRC usually treat under surgery to remove cancerous
polyps or to remove some part of their colon which have been affected (colon
resection). Chemotherapy and radiotherapy is other way to treat CRC but
these treatment are sometimes unsuccesful. Many recent findings said
probiotics has beneficial effect fot colorectal cancer because microbial
imbalance can trigger inflammatory process which may produce carcinogenic.
Probiotics can used as for the prevention and treatment of CRC because their
beneficial to protect against pathogens, regulating host immunity, and
strengthening the gut integrity. Probiotics play an essential role in the stability
of the microbiological environment. Probiotics has the efficacy in patients
with CRC.
2. METHODS
2.1 Protocol and Registration
The Preferred Reporting Items for Systematic Review and Meta-
Analysis (PRISMA) statement was used to perform this systematic review.

2.2 Eligibility Criteria

This systematic analysis includes all original studies on the subject
of probiotics as role of colorectal cancer. Electronic databases such as
Pubmed, PMC and Science Direct were used to gather studies from late
2017 to early 2022. English studies, studies related to the subject, and
matching with required variables are among the inclusion criteria. Studies
assesing effect probiotic to colorectal cancer patient.

2.3 Search Strategy

The literature search took place from February 26th to March 23th,
2022. The studies were found using the keywords or search phrases
"probiotic" AND "colorectal cancer" in electronic databases such as
Pubmed and PMC. The study's publication year was limited to late 2017 to
early 2022, and only published English or Indonesian papers were
allowed.
Table 1. The terminology used in search queries

Location Terminology Hits Selected

Pubmed (probiotic) AND (colorectal 62 3

cancer) OR (probiotic) AND
(colorectal cancer)

PMC (probiotic) AND (colorectal 3342 2

cancer) OR (probiotic) AND
(colorectal cancer)

Science (probiotic) AND (colorectal 197 2

Direct cancer) OR (probiotic) AND
(colorectal cancer)

2.4 Data Collection/ Study Selection

 We extensively searching in three different databases (PubMed,
PMC, Science Direct) since 2017 until 2022 to find original article which
relate to the role of probiotics to patients with colorectal cancer. We also
used keywords to focused about relevant article. Each study's first author,
year of publication, and outcomes were independently collected and
reported by the authors.
The collected studies were selected by title, abstracts, and
keywords from papers found through a search. Partially read the papers
collected to assess their suitability for future research. We also looked
through the reference lists of the papers we chose for analysis to see if any
other studies were psychology relevant. Articles that met the inclusion
criteria were routinely selected, screened, and analyzed. Three articles
were discovered during the search and search operation. The search and
search process turned up three papers that met the criteria for inclusion and
exclusion. A table was used to summarize and present the results.

2.5 Quality Assessment and Data Synthesis

The authors reviewed the articles selected via the screening method
for data extraction. Any discrepancies between reviewers were addressed
until a solution was found. The key results and characteristics of each
analysis are then extracted using the data extraction table.

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