Purpose: This review evaluates the potential role of kombucha in Colorectal Cancer (CRC) prevention and adjunctive therapy through the microbiota–metabolite–host axis, emphasizing bioactive compounds, fermentation metabolites, gut microbiota, oxidative-inflammatory pathways, immune responses, and carcinogenesis.
Methods: A review of studies published between 2015 and 2025 was conducted using PubMed, ScienceDirect, and Google Scholar. Experimental, preclinical, clinical, and review evidence on kombucha, fermented tea, microbiota, microbial metabolites, probiotics, prebiotics, oxidative stress, inflammation, CRC, and anticancer mechanisms was synthesized.
Results: Kombucha may modulate the gut microbiota, metabolism, oxidative stress, inflammation, immunity, proliferation, and apoptosis through its bioactive compounds. However, evidence for the prevention or treatment of CRC remains largely preclinical.
Conclusions: Kombucha may provide a mechanistic basis for investigating its use as a dietary adjunct for CRC prevention and supportive care; however, its therapeutic efficacy requires confirmation in human studies.
Limitations: Evidence is limited by heterogeneous fermentation conditions, composition, microbial communities, metabolite profiles, insufficient strain-specific characterization, and scarce standardized human interventions.
Contributions: This review integrates kombucha evidence within a microbiota–metabolite–host framework, connecting fermented tea bioactives, microbial ecology, metabolite signaling, intestinal homeostasis, and CRC pathways, while identifying priorities for metabolomic, microbiome, mechanistic, and clinical research.