Fig. 1

Study design and patient selection. In total, 379 patients were tested using targeted NGS. The case group are patients with at least one APC variant fitting colibactin-associated mutational signature. Twenty cases are selected for additional fecal metagenomics and WGS. Patients without APC variant fitting colibactin-associated signatures serve as controls. Nine controls were selected for fecal metagenomics and WGS. Four patients could not be included for fecal metagenomics since they did not respond to sample request (N = 3) or passed away (N = 1). Two cases were excluded for WGS due to insufficient amount of DNA