Post-diagnosis dietary factors, supplement use and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis

Doris S.M. Chan*, Margarita Cariolou, Georgios Markozannes, Katia Balducci, Rita Vieira, Sonia Kiss, Nerea Becerra-Tomás, Dagfinn Aune, Darren C. Greenwood, Esther M. González-Gil, Ellen Copson, Andrew G. Renehan, Martijn Bours, Wendy Demark-Wahnefried, Melissa M. Hudson, Anne M. May, Folakemi T. Odedina, Roderick Skinner, Karen Steindorf, Anne TjønnelandGalina Velikova, Monica L. Baskin, Rajiv Chowdhury, Lynette Hill, Sarah J. Lewis, Jaap Seidell, Matty P. Weijenberg, John Krebs, Amanda J. Cross, Konstantinos K. Tsilidis

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

4 Citationer (Scopus)
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Abstract

The role of diet in colorectal cancer prognosis is not well understood and specific lifestyle recommendations are lacking. We searched for randomised controlled trials (RCTs) and longitudinal observational studies on post-diagnosis dietary factors, supplement use and colorectal cancer survival outcomes in PubMed and Embase from inception until 28th February 2022. Random-effects dose–response meta-analyses were conducted when at least three studies had sufficient information. The evidence was interpreted and graded by the CUP Global independent Expert Committee on Cancer Survivorship and Expert Panel. Five RCTs and 35 observational studies were included (30,242 cases, over 8700 all-cause and 2100 colorectal cancer deaths, 3700 progression, recurrence, or disease-free events). Meta-analyses, including 3–10 observational studies each, were conducted for: whole grains, nuts/peanuts, red and processed meat, dairy products, sugary drinks, artificially sweetened beverages, coffee, alcohol, dietary glycaemic load/index, insulin load/index, marine omega-3 polyunsaturated fatty acids, supplemental calcium, circulating 25-hydroxyvitamin D (25[OH]D) and all-cause mortality; for alcohol, supplemental calcium, circulating 25(OH)D and colorectal cancer-specific mortality; and for circulating 25(OH)D and recurrence/disease-free survival. The overall evidence was graded as ‘limited’. The inverse associations between healthy dietary and/or lifestyle patterns (including diets that comprised plant-based foods), whole grains, total, caffeinated, or decaffeinated coffee and all-cause mortality and the positive associations between unhealthy dietary patterns, sugary drinks and all-cause mortality provided ‘limited—suggestive’ evidence. All other exposure-outcome associations provided ‘limited—no conclusion’ evidence. Additional, well-conducted cohort studies and carefully designed RCTs are needed to develop specific lifestyle recommendations for colorectal cancer survivors.
OriginalsprogEngelsk
TidsskriftInternational Journal of Cancer
Vol/bind155
Udgave nummer3
Sider (fra-til)445-470
Antal sider26
ISSN0020-7136
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
This work was funded by the World Cancer Research Fund network of charities (American Institute for Cancer Research [AICR]; World Cancer Research Fund [WCRF]; Wereld Kanker Onderzoek Fonds [WKOF]) (CUP Global Special Grant 2018). The funders of this study had no role in the decisions about the design and conduct of the study; collection, management, analysis, or interpretation of the data; or the preparation, review, or approval of the manuscript. The process used was based on the method developed by WCRF International's Methodology Task Force for the WCRF/AICR Second Expert Report. The views expressed in this review are the opinions of the authors. They may differ from those in future updates of the evidence related to food, nutrition, physical activity, and cancer incidence and survival.

Publisher Copyright:
© 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

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