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-Tomas, Nerea
AU - Aune, Dagfinn
AU - Greenwood, Darren C.
AU - Gonzalez-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 - Tjonneland, 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.
PY - 2024/8/1
Y1 - 2024/8/1
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
KW - VITAMIN-D STATUS
KW - ALL-CAUSE MORTALITY
KW - C-REACTIVE PROTEIN
KW - QUALITY-OF-LIFE
KW - COLON-CANCER
KW - 25-HYDROXYVITAMIN D
KW - PHYSICAL-ACTIVITY
KW - DAIRY-PRODUCTS
KW - INSULIN SCORES
KW - PROCESSED MEAT
U2 - 10.1002/ijc.34906
DO - 10.1002/ijc.34906
M3 - (Systematic) Review article
SN - 0020-7136
VL - 155
SP - 445
EP - 470
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 3
ER -