Back to basic – dietary microbial modulation for colorectal cancer prevention – for Hong Kong Chinese

Colorectal cancer [CRC] is one of the most common malignancies worldwide [1]. According to Globocan 2018, there were 18 million newly diagnosed cancer cases worldwide, while CRC made up 10.2%, topped the third highest cancer incidence. In the same year, CRC had the second highest mortality rate with more than 880,000 lives lost to it [2]. The environmental and heritable factors of colorectal cancer [CRC] is around 35% [3]. Up to 3%-5% of all CRC are represented by the hereditary syndromes [4]. Meanwhile, a higher incidence of CRC is observed in more developed regions than under developed regions, and changes in lifestyle and dietary habits are believed to attribute to an increased incidence [1,5]. In Hong Kong, CRC has been the most common cancer since 2013 [6], with more than 5,000 new diagnoses annually, accounts for 50.8% male, 31.5% female with an upward trend in 2017 [7]. The dietary habits of people in Hong Kong have steered away from the traditional Chinese diet, to fast-pace dining comprised of processed food and reduced diversity. Although the association between microbiota and the risk of CRC is indistinct, the undoubted fact is that CRC patients have less diverse microbiota than their healthy counter parts [8]. In this commentary, we would like to discuss the potential benefi ts of resuming a traditional diet which is relatively similar to the Mediterranean diet to modulate microbial risk in CRC in Hong Kong Chinese. Microbial risk in developing CRC