TY - JOUR
T1 - Dietary patterns and colorectal cancer risk
T2 - Global Cancer Update Programme (CUP Global) systematic literature review
AU - Chu, Anne HY
AU - Lin, Kehuan
AU - Croker, Helen
AU - Kefyalew, Sarah
AU - Becerra-Tomás, Nerea
AU - Dossus, Laure
AU - González-Gil, Esther M.
AU - Ahmadi, Nahid
AU - Park, Yikyung
AU - Krebs, John
AU - Weijenberg, Matty P.
AU - Baskin, Monica L.
AU - Copson, Ellen
AU - Lewis, Sarah J.
AU - Seidell, Jacob C.
AU - Chowdhury, Rajiv
AU - Hill, Lynette
AU - Chan, Doris SM
AU - Lee, Dong Hoon
AU - Giovannucci, Edward L.
N1 - Publisher Copyright:
© 2025
PY - 2025/5
Y1 - 2025/5
N2 - Background: The 2018 World Cancer Research Fund/American Institute for Cancer Research Third Expert Report, including studies up to 2015, determined limited–no conclusion evidence on dietary patterns and colorectal cancer (CRC) risk due to insufficient data and varying pattern definitions. Objectives: This updated review synthesized literature on dietary patterns and CRC risk/mortality. Methods: PubMed and Embase were searched through 31 March, 2023, for randomized controlled trials (RCTs) and prospective cohort studies on adulthood dietary patterns. Patterns were categorized by derivation method: a priori, a posteriori, or hybrid, and were then descriptively reviewed in relation to the primary outcomes: CRC risk or mortality. The Global Cancer Update Programme Expert Committee and Expert Panel independently graded the evidence on the likelihood of causality using predefined criteria. Results: Thirty-two dietary scores from 53 observational studies and 3 RCTs were reviewed. Limited–suggestive evidence was concluded for higher alignment with a priori–derived patterns: Mediterranean, healthful plant-based index, Healthy Eating Index (HEI)/alternate HEI, and Dietary Approaches to Stop Hypertension (DASH), in relation to lower CRC risk. Common features across these diets included high plant-based food intake and limited red/processed meat. Hybrid-derived patterns: the empirical dietary index for hyperinsulinemia (EDIH) and the empirical dietary inflammatory pattern (EDIP), showed strong–probable evidence for increased CRC risk. Evidence for a priori–derived low-fat dietary interventions and a posteriori–derived patterns was graded as limited–no conclusion. By cancer subsite, higher alignment with Mediterranean diet showed limited–suggestive evidence for lower rectal cancer risk, and that with HEI/alternate HEI and DASH showed limited–suggestive evidence for lower colon and rectal cancer risks. EDIH and EDIP showed strong–probable evidence for increased colon cancer risks. All exposure–mortality pairs and other pattern–outcome associations were graded as limited–no conclusion. Conclusions: This review highlights the role of dietary patterns in CRC risk/mortality, providing insights for future research and public health strategies. This review was registered at PROSPERO as CRD42022324327 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324327).
AB - Background: The 2018 World Cancer Research Fund/American Institute for Cancer Research Third Expert Report, including studies up to 2015, determined limited–no conclusion evidence on dietary patterns and colorectal cancer (CRC) risk due to insufficient data and varying pattern definitions. Objectives: This updated review synthesized literature on dietary patterns and CRC risk/mortality. Methods: PubMed and Embase were searched through 31 March, 2023, for randomized controlled trials (RCTs) and prospective cohort studies on adulthood dietary patterns. Patterns were categorized by derivation method: a priori, a posteriori, or hybrid, and were then descriptively reviewed in relation to the primary outcomes: CRC risk or mortality. The Global Cancer Update Programme Expert Committee and Expert Panel independently graded the evidence on the likelihood of causality using predefined criteria. Results: Thirty-two dietary scores from 53 observational studies and 3 RCTs were reviewed. Limited–suggestive evidence was concluded for higher alignment with a priori–derived patterns: Mediterranean, healthful plant-based index, Healthy Eating Index (HEI)/alternate HEI, and Dietary Approaches to Stop Hypertension (DASH), in relation to lower CRC risk. Common features across these diets included high plant-based food intake and limited red/processed meat. Hybrid-derived patterns: the empirical dietary index for hyperinsulinemia (EDIH) and the empirical dietary inflammatory pattern (EDIP), showed strong–probable evidence for increased CRC risk. Evidence for a priori–derived low-fat dietary interventions and a posteriori–derived patterns was graded as limited–no conclusion. By cancer subsite, higher alignment with Mediterranean diet showed limited–suggestive evidence for lower rectal cancer risk, and that with HEI/alternate HEI and DASH showed limited–suggestive evidence for lower colon and rectal cancer risks. EDIH and EDIP showed strong–probable evidence for increased colon cancer risks. All exposure–mortality pairs and other pattern–outcome associations were graded as limited–no conclusion. Conclusions: This review highlights the role of dietary patterns in CRC risk/mortality, providing insights for future research and public health strategies. This review was registered at PROSPERO as CRD42022324327 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324327).
KW - adult
KW - colorectal cancers
KW - dietary patterns
KW - epidemiology
KW - incidences
KW - mortalities
KW - prospective studies
KW - public health
KW - randomized controlled trial
KW - review
UR - http://www.scopus.com/inward/record.url?scp=105000431936&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=105000431936&partnerID=8YFLogxK
U2 - 10.1016/j.ajcnut.2025.02.021
DO - 10.1016/j.ajcnut.2025.02.021
M3 - Article
C2 - 40010692
AN - SCOPUS:105000431936
SN - 0002-9165
VL - 121
SP - 999
EP - 1016
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 5
ER -