TY - JOUR

T1 - Post-diagnosis dietary factors, supplement use and colorectal cancer prognosis

T2 - A Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis

AU - Chan, Doris S.M.

AU - Cariolou, Margarita

AU - Markozannes, Georgios

AU - Balducci, Katia

AU - Vieira, Rita

AU - Kiss, Sonia

AU - Becerra-Tomás, Nerea

AU - Aune, Dagfinn

AU - Greenwood, Darren C.

AU - González-Gil, Esther M.

AU - Copson, Ellen

AU - Renehan, Andrew G.

AU - Bours, Martijn

AU - Demark-Wahnefried, Wendy

AU - Hudson, Melissa M.

AU - May, Anne M.

AU - Odedina, Folakemi T.

AU - Skinner, Roderick

AU - Steindorf, Karen

AU - Tjønneland, Anne

AU - Velikova, Galina

AU - Baskin, Monica L.

AU - Chowdhury, Rajiv

AU - Hill, Lynette

AU - Lewis, Sarah J.

AU - Seidell, Jaap

AU - Weijenberg, Matty P.

AU - Krebs, John

AU - Cross, Amanda J.

AU - Tsilidis, Konstantinos K.

N1 - Publisher Copyright: © 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

PY - 2024

Y1 - 2024

N2 - 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.

AB - 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.

KW - colorectal cancer survival

KW - diet

KW - evidence grading

KW - food

KW - systematic review

U2 - 10.1002/ijc.34906

DO - 10.1002/ijc.34906

M3 - Journal article

C2 - 38692645

AN - SCOPUS:85192150870

VL - 155

SP - 445

EP - 470

JO - Acta - Unio Internationalis Contra Cancrum

JF - Acta - Unio Internationalis Contra Cancrum

SN - 0898-6924

IS - 3

ER -