AI, Microbes and Your Gut - A New Way to Think About Cancer Prevention

Former Dean of the Faculty of Medicine at The Chinese University of Hong Kong (CUHK), Choh-Ming Li Professor of Medicine and Therapeutics, codirector of Microbiota I-Center (MagIC), Gastroenterologist

For many years, the gut microbiome, the invisible community living inside each of us has been a source of fascination. These trillions of bacteria are not merely passengers; they play a critical role in our health, influencing everything from digestion to immune defence. Recently, researchers at The Chinese University of Hong Kong have uncovered new ways to use this knowledge to tackle one of Asia’s most pressing health issues: colorectal cancer.

Colorectal cancer is a leading cause of cancer deaths across Asia, including Malaysia, where it ranks among the top cancers affecting both men and women. While regular screening remains essential, many people delay or avoid colonoscopies due to discomfort and fear. This has driven researchers at CUHK’s MagIC to explore novel strategies that could help prevent cancer before it develops.

The gut-cancer connection
It is long suspected that the bacteria in the gut influences the risk of colorectal cancer. But until recently, there was a lack of detailed insight into which bacteria matter most, especially for Asian populations whose gut microbiomes differ from those studied in Western countries.

MagIC’s research identified three bacterial species closely linked to colorectal cancer and its precursors - Fusobacterium nucleatum, Clostridium hathewayi, and Lachnoclostridium (often called the “M3” group). These bacteria contribute to inflammation, damage the gut lining, and may encourage tumour growth.

Colorectal cancer doesn’t start suddenly. It develops in a gut environment where harmful bacteria flourish, and protective ones dwindle. The challenge was to read this microbial map clearly and find ways to restore balance.

Mapping the Asian microbiome with artificial intelligence
To do this, MagIC built the first large-scale Asian gut microbiome database, using metagenomic sequencing - a technique that analyses all genetic material from microbial communities in stool samples. Combining this with artificial intelligence allowed us to identify microbial patterns specifically associated with colorectal cancer risk in Asians.

This was crucial because much of the existing microbiome data comes from Western populations, which may not fully represent microbial profiles in Asia. An Asian-first approach ensures that any intervention developed is relevant and effective for local communities.

Precision probiotics: A new frontier
Armed with these insights, CUHK and MagIC designed a precision probiotic formula to target and reduce these cancer-associated bacteria while encouraging the growth of beneficial species such as Bifidobacteria and Streptococcus thermophilus. To protect the microbes until they reach the gut, a patented microencapsulation technology was applied.

In a pilot study with 21 participants, the results were encouraging. After 3 months of daily probiotic use:

●      C. hathewayi dropped by 83 percent

●      F. nucleatum decreased by 23%

●      Lachnoclostridium fell by 37 percent.

●      The overall microbial risk score for colorectal cancer reduced by 52 percent.

●      Beneficial bacteria increased by 43 percent

●      Gut barrier function improved, reducing intestinal permeability by 33 percent, which may lower systemic inflammation

Importantly, participants tolerated the probiotic well, and many reported relief in digestive symptoms such as bloating, constipation and diarrhoea.

Why this matters for Malaysia and Beyond
Colorectal cancer is on the rise in Malaysia, reflecting lifestyle changes such as diet and reduced physical activity. Early detection through screening saves lives, but prevention remains a better strategy.

This research points towards a future where we can identify individuals at high risk through non-invasive stool testing and then offer personalised probiotics to rebalance their gut microbiome. This could complement existing screening programmes, improving outcomes while reducing discomfort and anxiety.

This approach is inspired by how the medical community addressed Helicobacter pylori, a bacterium linked to stomach ulcers and cancer. Once its pathogenic role in was deciphered, targeted treatments  were developed that have since reduced gastric cancer rates.

Similarly, microbiome modulation could become a key part of colorectal cancer prevention strategies. It moves us away from one-size-fits-all advice to a precision medicine model tailored to the individual’s unique gut environment.

A cautious but hopeful outlook
To be clear, this probiotic formula is not a cure, nor a replacement for traditional screening methods. Larger and longer-term clinical trials are necessary to confirm its effectiveness on a broader scale.

However, this marks an important shift in how we think about colorectal cancer - from a disease driven only by genetics and lifestyle to one also influenced by microbial ecology.

The gut is a complex ecosystem, and by understanding it better, medicine now has the tools to shape that environment in ways that could prevent serious disease.

Note: As a gastroenterologist and researcher, this intersection of microbiome science and artificial intelligence deeply exciting. It shows how emerging technologies can be harnessed to improve public health in practical, meaningful ways.

If we listen to our gut, both instinctively and scientifically, we may reduce the burden of colorectal cancer for future generations.