Colorectal cancer is one of the most common causes of cancer morbidity both in men and in women. However, females over 65 years old show higher mortality and lower 5-year survival rate of colorectal cancer compared to their age-matched male counterparts. The objective of this review is to suggest gender-based innovations to improve colorectal cancer outcomes in females. Women have a higher risk of developing right-sided (proximal) colon cancer than men, which is associated with more aggressive form of neoplasia compared to left-sided (distal) colon cancer. Despite differences in tumor location between women and men, most of scientific researchers do not consider sex specificity for study design and interpretation. Also, colorectal cancer screening guidelines do not distinguish females from male, which may explain the higher frequency of more advanced neoplasia when tumors are first detected and false negative results in colonoscopy in females. Moreover, socio-cultural barriers within females are present to delay screening and diagnosis. Few studies, among studies that included both men and women, have reported sex-specific estimates of dietary risk factors which are crucial to establish cancer prevention guidelines despite sex- and gender-associated differences in nutrient metabolism and dietary practices. Furthermore, anti-cancer drug use for colorectal cancer treatment can cause toxicity to the reproductive system, and gender-specific recurrence and survival rates are reported. Therefore, by understanding sex- and gender-related biological and socio-cultural differences in colorectal cancer risk, gender-specific strategies for screening, treatment and prevention protocols can be established to reduce the mortality and improve the quality of life.

ObjectiveTo investigate the functional effects of probiotic treatment on the gut microbiota, as well as liver and adipose gene expression in diet-induced obese mice.DesignMale C57BL/6J mice were fed a high-fat diet (HFD) for 8 weeks to induce obesity, and then randomized to receive HFD+probiotic (Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032, n = 9) or HFD+placebo (n = 9) for another 10 weeks. Normal diet (ND) fed mice (n = 9) served as non-obese controls.ResultsDiet-induced obese mice treated with probiotics showed reduced body weight gain and fat accumulation as well as lowered plasma insulin, leptin, total-cholesterol and liver toxicity biomarkers. A total of 151,061 pyrosequencing reads for fecal microbiota were analyzed with a mean of 6,564, 5,274 and 4,464 reads for the ND, HFD+placebo and HFD+probiotic groups, respectively. Gut microbiota species were shared among the experimental groups despite the different diets and treatments. The diversity of the gut microbiota and its composition were significantly altered in the diet-induced obese mice and after probiotic treatment. We observed concurrent transcriptional changes in adipose tissue and the liver. In adipose tissue, pro-inflammatory genes (TNFα, IL6, IL1β and MCP1) were down-regulated in mice receiving probiotic treatment. In the liver, fatty acid oxidation-related genes (PGC1α, CPT1, CPT2 and ACOX1) were up-regulated in mice receiving probiotic treatment.ConclusionsThe gut microbiota of diet-induced obese mice appears to be modulated in mice receiving probiotic treatment. Probiotic treatment might reduce diet-induced obesity and modulate genes associated with metabolism and inflammation in the liver and adipose tissue.

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