Vanessa Garcia-Larsen1,2, Victoria Morton3, Teresa Norat3, André Moreira4, James F Potts5, Tim Reeves6, Ioannis Bakolis7,8. 1. 2 Program in Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. vgla@jhu.edu. 2. Population Health and Occupational Medicine Group, National Heart and Lung Institute, Imperial College London, London, UK. vgla@jhu.edu. 3. School of Public Health, Imperial College London, London, UK. 4. Immuno-allergology, Hospital São João & Immunology, Faculty of Medicine, University of Porto, Porto, Portugal. 5. Population Health and Occupational Medicine Group, National Heart and Lung Institute, Imperial College London, London, UK. 6. National Guideline Alliance (NGA), Royal College of Obstetricians and Gynaecologists, London, UK. 7. Department of Biostatistics and Health Informatics, Kings College London, London, UK. 8. Health Services and Population Research Department, Kings College London, London, UK.
Abstract
BACKGROUND AND AIM: Colorectal cancer (CRC) is highly prevalent worldwide, with dietary habits being a major risk factor. We systematically reviewed and meta-analysed the observational evidence on the association between CRC and dietary patterns (DP) derived from principal component analysis. DESIGN: PRISMA guidelines were followed. Web of Science, Medline/PubMed, EMBASE, and The Cochrane Library were searched to identify all eligible papers published up to the 31st July 2017. Any pre-defined cancer of the colon was included, namely colon-rectal cancer (CRC), colon cancer (CC), rectal cancer (RC), or proximal and distal CC, if available. Western (WDP) and prudent (PDP) dietary patterns were compared as a proxy to estimate "unhealthy" (Rich in meat and processed foods) and "healthy" diets (containing fruits or vegetables), respectively. Meta-analyses were carried out using random effects model to calculate overall risk estimates. Relative risks (RR) and 95% confidence intervals were estimated comparing the highest versus the lowest categories of dietary patterns for any of the forms of colon cancer studied. RESULTS: 28 studies were meta-analysed. A WDP was associated with increased risk of CRC (RR 1.25; 95% CI 1.11, 1.40), and of CC (RR 1.30; 95% CI 1.11, 1.52). A PDP was negatively associated with CRC (RR 0.81; 95% CI 0.73, 0.91). Sensitivity analyses showed that individuals from North-and South-American countries had a significantly higher risk of CRC than those from other continents. CONCLUSION: A PDP might reduce the risk of CRC. Conversely, a WDP is associated with a higher risk of disease.
BACKGROUND AND AIM: Colorectal cancer (CRC) is highly prevalent worldwide, with dietary habits being a major risk factor. We systematically reviewed and meta-analysed the observational evidence on the association between CRC and dietary patterns (DP) derived from principal component analysis. DESIGN: PRISMA guidelines were followed. Web of Science, Medline/PubMed, EMBASE, and The Cochrane Library were searched to identify all eligible papers published up to the 31st July 2017. Any pre-defined cancer of the colon was included, namely colon-rectal cancer (CRC), colon cancer (CC), rectal cancer (RC), or proximal and distal CC, if available. Western (WDP) and prudent (PDP) dietary patterns were compared as a proxy to estimate "unhealthy" (Rich in meat and processed foods) and "healthy" diets (containing fruits or vegetables), respectively. Meta-analyses were carried out using random effects model to calculate overall risk estimates. Relative risks (RR) and 95% confidence intervals were estimated comparing the highest versus the lowest categories of dietary patterns for any of the forms of colon cancer studied. RESULTS: 28 studies were meta-analysed. A WDP was associated with increased risk of CRC (RR 1.25; 95% CI 1.11, 1.40), and of CC (RR 1.30; 95% CI 1.11, 1.52). A PDP was negatively associated with CRC (RR 0.81; 95% CI 0.73, 0.91). Sensitivity analyses showed that individuals from North-and South-American countries had a significantly higher risk of CRC than those from other continents. CONCLUSION: A PDP might reduce the risk of CRC. Conversely, a WDP is associated with a higher risk of disease.
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