Associations between degree of food processing and colorectal cancer risk in a large‐scale European cohort
2025
Al Nahas, Aline | Yammine Ghantous, Sahar | Morales Berstein, Fernanda | Koc Cakmak, Emine | Biessy, Carine | Nicolas, Genevieve | Kliemann, Nathalie | Blanco Lopez, Jessica | Jacobs, Inarie | M. Gonzalez‐gil, Esther | Cairat, Manon | Gabriela Matias Pinho, Maria | Bertazzi Levy, Renata | Rauber, Fernanda | P. Vamos, Eszter | Chang, Kiara | Millett, Christopher | Touvier, Mathilde | Kesse‐guyot, Emmanuelle | Severi, Gianluca | Marques, Chloé | Hajji, Mariem | Macciotta, Alessandra | Masala, Giovanna | Fordellone, Mario | Agnoli, Claudia | Amiano, Pilar | Guevara, Marcela | Tjønneland, Anne | Kyrø, Cecilie | W. G. Derksen, Jeroen | C. Smit, Karel | B. Schulze, Matthias | Jannasch, Franziska | Kaaks, Rudolf | Katzke, Verena | Braaten, Tonje | Brustad, Magritt | Skeie, Guri | Harewood, Rhea | Heath, Alicia | Vineis, Paolo | Weiderpass, Elisabete | Ferrari, Pietro | J. Gunter, Marc | Huybrechts, Inge | Centre international de Recherche sur le Cancer (CIRC) | Nutritional Epidemiology Research Team | Equipe de Recherche en Epidémiologie Nutritionnelle (EREN [CRESS - U1153 / UMR_A 1125]) ; Conservatoire National des Arts et Métiers [Cnam] (Cnam)-Université Sorbonne Paris Nord-Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques (CRESS (U1153 / UMR_A 1125)) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | University of Bristol [Bristol] | Imperial College London | Cancer Research Center | Centro de Pesquisas Oncológicas [Santa Catarina] (CEPON) | Université Paris-Saclay | Université de Versailles Saint-Quentin-en-Yvelines (UVSQ) | Institut National de la Santé et de la Recherche Médicale (INSERM) | Centre de recherche en épidémiologie et santé des populations (CESP) ; Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay | Universiteit Utrecht / Utrecht University [Utrecht] | Vrije Universiteit Amsterdam [Amsterdam] (VU) | Amsterdam University Medical Centers (Amsterdam UMC) | Universidade de São Paulo = University of São Paulo (USP) | Università degli Studi di Firenze = University of Florence = Université de Florence (UniFI) | Università degli studi di Torino = University of Turin (UNITO) | Università degli Studi del Piemonte Orientale - Amedeo Avogadro (UPO) | Istituto per lo studio, la prevenzione e la rete oncologica = Institute for Cancer Research, Prevention and Clinical Network (ISPRO) | Università degli studi della Campania "Luigi Vanvitelli" = University of the Study of Campania Luigi Vanvitelli | IRCCS Istituto Nazionale dei Tumori [Milano] | BioDonostia Health Research Institute = Instituto de Investigación Sanitaria Biodonostia | Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health (CIBERESP) | University of Copenhagen = Københavns Universitet (UCPH) | University Medical Center [Utrecht] (UMCU) | University of Potsdam = Universität Potsdam | Universität Heidelberg [Heidelberg] = Heidelberg University | Nord University [Bodø] | The Arctic University of Norway [Tromsø, Norway] (UiT) | World Cancer Research Fund International. Grant Number: IIG_FULL_2020_033 | Institut National Du Cancer. Grant Number: INCa number 2021-138 | Cancer Research UK Manchester Centre. Grant Number: C33493/A29678 | Cancer Research UK. Grant Numbers: 14136, C8221/A29017 | Medical Research Council. Grant Numbers: 1000143, MR/M012190/1 | Wellcome Trust PhD studentship in Molecular, Genetic and Lifecourse Epidemiology. Grant Number: 224982/Z/22/Z | Ministry of National Education, Türkiye
International audience
Mostrar más [+] Menos [-]Inglés. Industrial food processing has been linked to various health outcomes including cancer. To examine associations between the degree of food processing and risk of colorectal cancer (CRC) and its sub-sites, data from the European Prospective Investigation into Cancer (EPIC) including 6155 incident CRC cases (n = 450,111 participants), were analyzed. Dietary intakes were assessed using baseline food frequency questionnaires. Foods were classified into culinary ingredients, unprocessed, processed (PFs), and ultra-processed foods (UPFs) according to the Nova classification. Cox proportional hazards models, adjusted for established CRC risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) associated with a 10% increase in proportion of consumption (%g/d) of each Nova group. Substitution analysis examined the effect of replacing UPFs and PFs with unprocessed foods on CRC risk. A 10% increase in proportion of UPFs was associated with 6% higher CRC risk (95% CI:1.02-1.10). A positive association was also found between PFs and CRC risk (HR per 10% increase: 1.10 [95% CI, 1.05-1.15]). Conversely, unprocessed food consumption was inversely associated with CRC risk (HR per 10% increase: 0.93[95% CI, 0.90-0.95]). Substitution of 10% of the overall proportion of the diet comprising UPFs or PFs with 10% unprocessed foods was associated with a decreased risk of CRC (HRUPFs: 0.94 [95% CI, 0.90-0.97]; HRPFs: 0.90 [95% CI, 0.86-0.94]). In conclusion, UPF was positively associated with CRC risk while diets richer in unprocessed foods were associated with lower CRC risk. Further studies are needed to understand the mechanisms by which food processing affects CRC risk.
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