ARAF and colorectal carcinoma: Exclusion criteria included: (i) Studies focused on animals, (ii) Studies not focused on CRC or colibactin-associated CRC, (iii) non-peer-reviewed articles, and (iv) Studies not published in English. Studies published before 2010 were excluded as early research on pks+ E. coli was largely mechanistic, lacking robust epidemiological data, standardized detection methods, or validated human mutational signatures linking it to CRC.