ARAF and colorectal carcinoma: These studies demonstrate that E. coli alters its functional characteristics by inducing a more pathogenic phenotype, including an increase in its adherence and invasive abilities.48 A genotoxin encoded by the 54-kb polyketide synthase (PKS) genotoxicity island has been found in E. coli isolates from patients with IBD and CRC.49 Even gender-specific differences in CRC development has been linked to hemolytic type I E. coli, which is significantly associated with adenoma and CRC in female patients only.