Ultraprocessed Food Consumption and Risk of Early-Onset Colorectal Cancer Precursors Among Women
Wang C, Du M, Kim H, Nguyen LH, Wang QL, Drew DA, Leeming ER, Khandpur N, Sun Q, Zong X, Gweon TG, Ogino S, Ng K, Berry S, Giovannucci EL, Song M, Cao Y, Chan AT
JAMA oncology · 26 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Food frequency questionnaire
Who paid for it
- Funding
- Independent funding
- Government
- NCI NIH HHS
Based on 1 listed funder(s).
Publication
- Published
- 2025-11-13 · JAMA Oncol · vol. 12 · issue 1 · p. 49
- Publisher
- American Medical Association
- Cited
- 30 citations · more than 99% of similar papers · 12.6× the field average
- Impact
- Top 10% most cited in its field
- References
- 33 works
- Access
- Open access (repository copy)
- Research areas
- Colorectal Cancer Screening and Detection · Nutritional Studies and Diet · Consumer Attitudes and Food Labeling
- Keywords
- Colorectal cancer, MEDLINE, Food consumption, Consumption (sociology), Carcinogenesis, Colonic disease, Food group, Food intake
- MeSH
- humans, adenoma, colorectal neoplasms, diet, incidence, risk factors, prospective studies, feeding behavior, age of onset, food handling, adult, middle aged, female
18 authors
From US, GB, BR, NL, KR, JP
- Chen WangHarvard University; Massachusetts General Hospital
- Mengxi DuHarvard University; Massachusetts General Hospital
- Hanseul KimHarvard University; Massachusetts General Hospital
- Long H. NguyenHarvard University; Massachusetts General Hospital
- Qiao-Li WangHarvard University; Dana-Farber Cancer Institute
- David A. DrewHarvard University; Massachusetts General Hospital
Abstract
Importance
Early-onset colorectal cancer (EOCRC) (diagnosed age <50 years) incidence is increasing globally, in parallel with increased consumption of ultraprocessed foods (UPFs). The role of UPFs in early-onset colorectal neoplasia remains underexplored.
Objective
To evaluate the association between UPF consumption and risk of EOCRC precursors.
Design, setting, and participants
This prospective cohort study included participants of the Nurses' Health Study II, an ongoing US prospective cohort of female registered nurses established in 1989. Participants were followed up from June 1, 1991, through June 1, 2015. Data were analyzed from October 2024 to July 2025. UPF intake, derived from food-frequency questionnaires administered every 4 years and classified using the Nova system, was modeled as quintiles of energy-adjusted servings per day. Of the nurses enrolled, those who had completed the baseline 1991 food-frequency questionnaire, undergone at least 1 lower endoscopy before age 50 years after baseline, had no history of cancer (except for nonmelanoma skin cancer) before endoscopy, and no colorectal polyp or inflammatory bowel disease were included.
Main outcomes and measures
Incidence of EOCRC precursors, including conventional adenomas and serrated lesions, confirmed via medical records and pathology reports. Multivariable logistic regression models with generalized estimating equations for clustered data were used to estimate adjusted odds ratios (AORs) and 95% CIs, accounting for known and putative risk factors.
Results
Among 29 105 female participants (mean [SD] age, 45.2 [4.5] years) over 24 years of follow-up, 1189 cases were documented of early-onset conventional adenomas and 1598 serrated lesions. UPFs provided 34.8% of total daily calories (median, 5.7 [IQR, 4.5-7.4] servings per day). Participants with higher UPF intake had an increased risk of early-onset conventional adenomas (highest vs lowest intake: AOR, 1.45; 95% CI, 1.19-1.77; overall P < .001) but not serrated lesions (AOR, 1.04; 95% CI, 0.89-1.22; P = .48 for trend). Findings were consistent after further adjustment for body mass index, type 2 diabetes, dietary factors (fiber, folate, calcium, and vitamin D), and Alternative Healthy Eating Index-2010 score.
Conclusions and relevance
In this study, higher UPF intake was associated with increased risk of early-onset colorectal conventional adenomas. These data highlight the important role of UPFs in early-onset colorectal tumorigenesis and support improving dietary quality as a strategy to mitigate the increasing burden of EOCRC.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
Community trust
Loading…
How much do you trust this study's findings?
Comments
Sign in to rate, comment on or flag this study.Sign inSomething wrong here?
Flag this study if its information, labels or funding look wrong. An editor reviews every flag.
Sign in to rate, comment on or flag this study.Sign inEducational information about published research. Not medical advice, and not a recommendation to start or stop anything.