Gail Cresci, PhD, RD

Lerner Research Institute


Pilot Award

An Integrative Study of Diet, Gut “Omics” and Colonic Immunity to Elucidate Drivers of Racial Disparities in Colorectal Cancer Development

Colorectal cancer remains the third most commonly diagnosed cancer in the United States. African Americans have the highest incidence and mortality from colorectal cancer of all broadly defined racial/ethnic groups worldwide. Although some of the observed disparities can be attributed to access to care, it is also apparent that differences in the gut microbiome combined with environmental factors, including diet, are important contributing factors. Understanding how differences in the microbiome and its interaction with diet and tumor-associated immune responses in African American patients with and without advanced adenomas will enable us to better understand the disproportionate burden and inform future clinical interventions. In this project we will assess African Americans with and without advanced adenomas for differences in: 1) dietary patterns regarding its quality and inflammatory potential; 2) gut (stool and colon tissue) bacterial diversity and stool metabolites and their relationship with dietary patterns; and 3) tumor-associated T cell profiles in advanced colorectal adenomas and assess links with dietary indexes, gut bacteria and metabolites. The goal of this work is to inform the development and testing of a personalized, microbiome-driven dietary intervention among AA with advanced adenomas through a prospective randomized clinical trial.


We plan to study African Americans with and without colorectal cancer to identify their dietary patterns for its quality and inflammatory potential, as well as look at their gut biome and the metabolites produced. Then, we will look at the tumor itself for different immune cells that are within the tumor to see if there is a relationship between diet and the microbiome. The overall goal is to gain information to help inform us of future intervention.