Review Article | | Peer-Reviewed

Diet and Colorectal Cancer: A Comprehensive Systematic Review of Epidemiological Evidence

Received: 24 September 2026     Accepted: 8 October 2026     Published: 29 October 2026
Views:       Downloads:
Abstract

Colorectal cancer (CRC) ranks among the most prevalent cancers worldwide, with lifestyle factors including diet playing a crucial role in its development and progression. This systematic review aims to synthesize current epidemiological evidence on the associations between dietary factors and CRC risk, following PRISMA 2020 guidelines. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library databases for articles published between January 2000 and December 2025. The search strategy combined terms related to colorectal cancer, dietary factors, and risk factors. Studies were included if they examined human populations, assessed dietary exposures, reported CRC outcomes, and were observational studies, interventional trials, systematic reviews, or meta-analyses. Two reviewers independently screened records, extracted data, and assessed quality using Newcastle-Ottawa Scale, Cochrane RoB 2.0, and AMSTAR-2 tools of 3,150 initially identified records, 90 studies met inclusion criteria and were included in the systematic synthesis. The reviewed evidence indicates that high consumption of red and processed meats (RR: +12-18% per 100g/day), saturated fats, ultra-processed foods, alcohol (dose-dependent), and tobacco (RR: 2-3× vs. non-smokers) is associated with increased CRC risk. Conversely, diets rich in fiber, fruits, vegetables, whole grains, fish, olive oil, dairy products, and specific micronutrients (vitamins D, B-group, C, E, selenium, zinc) show inverse associations with CRC risk (20-50% risk reduction). Epidemiological studies suggest that modifiable lifestyle factors may influence CRC risk by approximately 60-70%, though these estimates derive primarily from observational data with moderate to high heterogeneity. This systematic review highlights the potential for CRC prevention through dietary modifications. However, due to the observational nature of most available evidence, further well-designed prospective studies and randomized controlled trials are needed to establish causal relationships. The findings should be interpreted as associations rather than causal effects.

Published in Science Journal of Public Health (Volume 14, Issue 5)
DOI 10.11648/j.sjph.20261405.13
Page(s) 235-252
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Colorectal Cancer, Risk Factors, Lifestyle, Diet

References
[1] Yang Y, Sun X, Wang J, Yang C, Zhang L. Incidence Rates of Four Major Non-Communicable Chronic Diseases in the Chinese Adult Population from 2007 to 2016: A Study Based on a National Commercial Claims Database. CLEP. 2020; Volume 12: 215-222.
[2] Williams J, Allen L, Wickramasinghe K, Mikkelsen B, Roberts N, Townsend N. A systematic review of associations between non-communicable diseases and socioeconomic status within low-and lower-middle-income countries. Journal of global health. 2018; 8(2). Accessed December 9, 2024.
[3] WHO. Noncommunicable diseases. 2023. Accessed December 9, 2024.
[4] Natik, A., & Fadel, S. (2017). Tumor growth in equations.
[5] Pecorino, L. (2021). Molecular biology of cancer : Mechanisms, targets, and therapeutics. Oxford university press.
[6] Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L. Global Cancer Observatory: Cancer Today (version 1.1). Lyon, France: International Agency for Research on Cancer. Published online 2024.
[7] Key TJ, Allen NE, Spencer EA, Travis RC. The effect of diet on risk of cancer. The Lancet. 2002; 360(9336): 861-868.
[8] Lavalette C, Adjibade M, Srour B, et al. Cancer-specific and general nutritional scores and cancer risk: results from the prospective NutriNet-Sante cohort. Cancer research. 2018; 78(15): 4427-4435.
[9] Murphy N, Moreno V, Hughes DJ, et al. Lifestyle and dietary environmental factors in colorectal cancer susceptibility. Molecular Aspects of Medicine. 2019; 69: 2-9.
[10] DeVita VT, Lawrence TS, Rosenberg SA. Colon and Other Gastrointestinal Cancers: Cancer: Principles & Practice of Oncology. Lippincott Williams & Wilkins; 2016.
[11] Bouregba S, Boulenouar FZ. Cancer Du Colon. PhD Thesis. 2015. Accessed September 17, 2024.
[12] Kadja MC, Mensah GA, Akomedi TC, Tomagnimèna GP, POMALEGNI S. Topography of the thoracic and abdominal viscera of the greater cane rat (*Thryonomys swinderianus*): right and left parietal projections. Bul Rec Agr Benin. 2007;(55): 35-44.
[13] Senouci L, Taib K. Literature Review on Colorectal Cancer. PhD Thesis. Mouloud Mammeri University; 2023. Accessed September 17, 2024.
[14] Thomusch O. Colon. In: Billmann F, Keck T, eds. Essentials of Visceral Surgery: For Residents and Fellows. Springer; 2023: 49-76.
[15] Roy JL. Gut-directed hypnotherapy: sunshine in the belly. Published online 2000. Accessed October 31, 2024.
[16] Koerner C, Morris A, Dinallo A, Shaffer V, Balch G. Colon. In: Hazen BJ, Maithel SK, Rajani RR, Srinivasan J, eds. Anatomic, Physiologic, and Therapeutic Principles of Surgical Diseases. Springer International Publishing; 2023: 221-248.
[17] Marieb EN. The Digestive System and Metabolism. Human Biology, 8th ed. Paris: P., 2008; 508.
[18] Silverthorn DU. Human Physiology: An Integrated Approach. Pearson Education France; 2007.
[19] Dekker E, Tanis PJ, Vleugels JL, Kasi PM, Wallace M. Colorectal cancer. Lancet. 2019; 394(10207): 1467-1480.
[20] Benbrika R. Study of the Mechanisms Involved in the Metastatic Process in Human Colon Cancer: Involvement of the CXCL12/CXCR4/CXCR7 Axis. PhD Thesis. University of Strasbourg; 2018. Accessed September 16, 2024.
[21] Tanaka T. Colorectal carcinogenesis: Review of human and experimental animal studies. J Carcinog. 2009; 8: 5.
[22] Gandomani HS, Yousefi SM, Aghajani M, et al. Colorectal cancer in the world: incidence, mortality and risk factors. Biomedical Research and Therapy. 2017; 4(10): 10.
[23] Filho AM, Laversanne M, Ferlay J, et al. The GLOBOCAN 2022 cancer estimates: Data sources, methods, and a snapshot of the cancer burden worldwide. Int J Cancer. 2025; 156(7): 1336-1346.
[24] Rodriguez A, Mastronardi C, Da Paz Filho G. Leptin as a risk factor for the development of colorectal cancer. Published online 2013.
[25] Zhang S, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2015. Journal of the National Cancer Center. 2021; 1(1): 2-11.
[26] Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA A Cancer J Clinicians. 2021; 71(3): 209-249.
[27] Tanwar NA, Malhotra R, Satheesh AP, et al. Understanding the Impact of Population and Cancer Type on Tumor Mutation Burden Scores: A Comprehensive Whole-Exome Study in Cancer Patients from India. JCO Global Oncology. 2023;(9): e2300047.
[28] Jung KW, Won YJ, Hong S, Kong HJ, Lee ES. Prediction of cancer incidence and mortality in Korea, 2020. Cancer Research and Treatment: Official Journal of Korean Cancer Association. 2020; 52(2): 351-358.
[29] Amini M, Rezasoltani S, Pourhoseingholi MA, Asadzadeh Aghdaei H, Zali MR. Evaluating the predictive performance of gut microbiota for the early-stage colorectal cancer. BMC Gastroenterol. 2022; 22(1): 514.
[30] Parkin DM, Bray F, Ferlay J, Jemal A. Cancer in africa 2012. Cancer Epidemiology, Biomarkers & Prevention. 2014; 23(6): 953-966.
[31] Lafay L, Ancellin R. Diet and colorectal cancer. Nutrition and Dietetics Notebooks. 2015; 50(5): 262-270.
[32] Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nature reviews Gastroenterology & hepatology. 2019; 16(12): 713-732.
[33] Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Gastroenterology Review/Przegląd Gastroenterologiczny. 2019; 14(2): 89-103.
[34] Saad F, McCormack M, McCormack M. Prostate Cancer. Annika Parance Publisher; 2019. Accessed September 17, 2024.
[35] Iltis C. Rôle de l'immunosurveillance Des Cellules Sénes-centes Dans Le Cancer et Le Vieillissement. Thèse de doctorat. Université Côte d'Azur; 2020. Accessed September 17, 2024.
[36] Ferlay J, Colombet M, Soerjomataram I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. International journal of cancer. 2019; 144(8): 1941-1953.
[37] Shams-White MM, Brockton NT, Mitrou P, et al. Operationalizing the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations: a standardized scoring system. Nutrients. 2019; 11(7): 1572.
[38] Kim SE, Paik HY, Yoon H, Lee JE, Kim N, Sung MK. Sex-and gender-specific disparities in colorectal cancer risk. World journal of gastroenterology: WJG. 2015; 21(17): 5167.
[39] Sawicki T, Ruszkowska M, Danielewicz A, Niedźwiedzka E, Arłukowicz T, Przybyłowicz KE. A review of colorectal cancer in terms of epidemiology, risk factors, development, symptoms and diagnosis. Cancers. 2021; 13(9): 2025.
[40] Chetty R, Stepner M, Abraham S, et al. The association between income and life expectancy in the United States, 2001-2014. Jama. 2016; 315(16): 1750-1766.
[41] Win AK, MacInnis RJ, Hopper JL, Jenkins MA. Risk prediction models for colorectal cancer: a review. Cancer epidemiology, biomarkers & prevention. 2012; 21(3): 398-410.
[42] Dyson JK, Rutter MD. Colorectal cancer in inflammatory bowel disease: what is the real magnitude of the risk? World J Gastroenterol. 2012; 18(29): 3839-3848.
[43] Faye AS, Holmer AK, Axelrad JE. Cancer in Inflammatory Bowel Disease. Gastroenterol Clin North Am. 2022; 51(3): 649-666.
[44] Eaden JA, Abrams KR, Mayberry J. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut. 2001; 48(4): 526-535.
[45] Long MD, Martin CF, Pipkin CA, Herfarth HH, Sandler RS, Kappelman MD. Risk of Melanoma and Nonmelanoma Skin Cancer Among Patients With Inflammatory Bowel Disease. Gastroenterology. 2012; 143(2): 390-399.e1.
[46] Hnatyszyn A, Hryhorowicz S, Kaczmarek-Ryś M, et al. Colorectal carcinoma in the course of inflammatory bowel diseases. Hered Cancer Clin Pract. 2019; 17(1): 18.
[47] Thelin C, Sikka S. Epidemiology of colorectal Cancer—incidence, lifetime risk factors statistics and temporal trends. Screening for colorectal Cancer with colonoscopy London: IntechOpen Limited. Published online 2015: 61-77.
[48] Shussman N, Wexner SD. Colorectal polyps and polyposis syndromes. Gastroenterol Rep (Oxf). 2014; 2(1): 1-15.
[49] Ma Y, Yang W, Song M, et al. Type 2 diabetes and risk of colorectal cancer in two large US prospective cohorts. British journal of cancer. 2018; 119(11): 1436-1442.
[50] Elwing JE, Gao F, Davidson NO, Early DS. Type 2 diabetes mellitus: the impact on colorectal adenoma risk in women. Official journal of the American College of Gastroenterology| ACG. 2006; 101(8): 1866-1871.
[51] Limburg PJ, Vierkant RA, Fredericksen ZS, et al. Clinically confirmed type 2 diabetes mellitus and colorectal cancer risk: a population-based, retrospective cohort study. Official journal of the American College of Gastroenterology| ACG. 2006; 101(8): 1872-1879.
[52] Oh SW, Kim YH, Choi YS, et al. The Comparison of the Risk Factors and Clinical Manifestations of Proximal and Distal Colorectal Cancer. Diseases of the Colon & Rectum. 2008; 51(1): 56-61.
[53] Ren X, Zhang X, Gu W, et al. Type 2 diabetes mellitus associated with increased risk for colorectal cancer: evidence from an international ecological study and population-based risk analysis in China. Public Health. 2009; 123(8): 540-544.
[54] Yang YX, Hennessy S, Lewis JD. Type 2 diabetes mellitus and the risk of colorectal cancer. Clinical Gastroenterology and Hepatology. 2005; 3(6): 587-594.
[55] Peeters PJ, Bazelier MT, Leufkens HG, de Vries F, De Bruin ML. The risk of colorectal cancer in patients with type 2 diabetes: associations with treatment stage and obesity. Diabetes care. 2015; 38(3): 495-502.
[56] Maamri A. Cancer & Nutrition. Annals of Health Sciences. 2016; 1(8): 8.
[57] Aglago EK, Bray F, Zotor F, et al. Temporal trends in food group availability and cancer incidence in Africa: an ecological analysis. Public health nutrition. 2019; 22(14): 2569-2580.
[58] World Cancer Research Fund International. Diet, Nutrition, Physical Activity and Cancer. WCRF International. 2018. Accessed September 19, 2024.
[59] De Smet S. Meat and cancer: a perspective. Meat & Meat Products. Published online 2018. Accessed September 19, 2024.
[60] Pierre F. Red meat, processed meat, and colorectal cancer. The central role of heme iron and the catalysis of lipid peroxidation. Towards nutritional prevention? Meat & Meat Products. Published online 2016: 1.
[61] Chan DS, Lau R, Aune D, et al. Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. PloS one. 2011; 6(6): e20456.
[62] Vieira AR, Abar L, Chan DSM, et al. Foods and beverages and colorectal cancer risk: a systematic review and meta-analysis of cohort studies, an update of the evidence of the WCRF-AICR Continuous Update Project. Annals of Oncology. 2017; 28(8): 1788-1802.
[63] Sugimura T. Nutrition and dietary carcinogens. Carcinogenesis. 2000; 21(3): 387-395.
[64] Crowe W, Elliott CT, Green BD. A review of the in vivo evidence investigating the role of nitrite exposure from processed meat consumption in the development of colorectal cancer. Nutrients. 2019; 11(11): 2673.
[65] Ntimbane T. Importance of oxidative stress in cystic fibrosis-related diabetes. Published online 2010. Accessed September 19, 2024.
[66] Nikkels A, Pierard C, Pierard G. Molecular Photobiology. Liege Medical Journal. 2005; 60. Accessed September 19, 2024.
[67] Järvinen R, Knekt P, Hakulinen T, Rissanen H, Heliövaara M. Dietary fat, cholesterol and colorectal cancer in a prospective study. Br J Cancer. 2001; 85(3): 357-361.
[68] Tang FYTFY, Pai Man Hui PMH, Chiang EnPei Chiang EPI. Consumption of high-fat diet induces tumor progression and epithelial-mesenchymal transition of colorectal cancer in a mouse xenograft model. Published online 2012. Accessed October 15, 2024.
[69] Song M, Garrett WS, Chan AT. Nutrients, foods, and colorectal cancer prevention. Gastroenterology. 2015; 148(6): 1244-1260.
[70] Yang J, Wei H, Zhou Y, et al. High-fat diet promotes colorectal tumorigenesis through modulating gut microbiota and metabolites. Gastroenterology. 2022; 162(1): 135-149.
[71] Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nature Reviews Cancer. 2004; 4(8): 579-591.
[72] Friedenreich CM, Ryder-Burbidge C, McNeil J. Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biologic mechanisms. Mol Oncol. 2021; 15(3): 790-800.
[73] Monteiro CA, Cannon G, Levy RB, et al. Ultra-processed foods: what they are and how to identify them. Public health nutrition. 2019; 22(5): 936-941.
[74] Isaksen IM, Dankel SN. Ultra-processed food consumption and cancer risk: A systematic review and meta-analysis. Clinical Nutrition. 2023; 42(6): 919-928.
[75] Kliemann N, Al Nahas A, Vamos EP, et al. Ultra-processed foods and cancer risk: from global food systems to individual exposures and mechanisms. British journal of cancer. 2022; 127(1): 14-20.
[76] Whelan K, Bancil AS, Lindsay JO, Chassaing B. Ultra-processed foods and food additives in gut health and disease. Nat Rev Gastroenterol Hepatol. 2024; 21(6): 406-427.
[77] Li YD, Fu YX, Gong LL, et al. Ultra-processed food consumption and renal cell carcinoma incidence and mortality: results from a large prospective cohort. BMC Med. 2024; 22(1): 459.
[78] Kuru-Yaşar R, Üstün-Aytekin Ö. The Crucial Roles of Diet, Microbiota, and Postbiotics in Colorectal Cancer. Curr Nutr Rep. 2024; 13(2): 126-151.
[79] WHO. Obesity. 2024. Accessed November 3, 2024.
[80] Kaufer M, Tavano L, Ávila H. Obesity in adults: Medical nutrition. Published online 2001.
[81] Basdevant A. Obesity: origins and consequences of an epidemic. Biology Reports. 2006; 329(8): 562-569.
[82] Fernández-Sánchez A, Madrigal-Santillán E, Bautista M, et al. Inflammation, oxidative stress, and obesity. International journal of molecular sciences. 2011; 12(5): 3117-3132.
[83] Chen Q, Wang J, Yang J, et al. Association between adult weight gain and colorectal cancer: A dose-response meta‐analysis of observational studies. Intl Journal of Cancer. 2015; 136(12): 2880-2889.
[84] WHO WH. Global Recommendations on Physical Activity for Health. Published online 2010. Accessed October 11, 2024.
[85] Cerin E. WCRF - Cancer, weight, and physical activity. Cerin. December 7, 2018. Accessed September 19, 2024.
[86] Clinton SK, Giovannucci EL, Hursting SD. The World Cancer Research Fund/American Institute for Cancer Research Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: Impact and Future Directions. J Nutr. 2020; 150(4): 663-671.
[87] Quintin I, Castetbon K, Mennen L, Hercberg S. Diet, nutrition, and cancer: Truths, hypotheses, and misconceptions. Published online 2003. Accessed October 11, 2024.
[88] Desnoyers A, Riesco E, Fülöp T, Pavic M. Physical activity and cancer: an update and literature review. The Journal of Internal Medicine. 2016; 37(6): 399-405.
[89] Duclos M. Physical activity and breast and colon cancer: physical activity based on scientific evidence. Science & Sports. 2009; 24(6): 273-280.
[90] Gandini S, Botteri E, Iodice S, et al. Tobacco smoking and cancer: A meta‐analysis. Intl Journal of Cancer. 2008; 122(1): 155-164.
[91] Botteri E, Iodice S, Bagnardi V, Raimondi S, Lowenfels AB, Maisonneuve P. Smoking and colorectal cancer: a meta-analysis. Jama. 2008; 300(23): 2765-2778.
[92] Giovannucci E. An updated review of the epidemiological evidence that cigarette smoking increases risk of colorectal cancer. Cancer Epidemiology Biomarkers & Prevention. 2001; 10(7): 725-731.
[93] Ahmed S, Johnson K, Ahmed O, Iqbal N. Advances in the management of colorectal cancer: from biology to treatment. Int J Colorectal Dis. 2014; 29(9): 1031-1042.
[94] Shields PG, Harris CC. Cancer Risk and Low-Penetrance Susceptibility Genes in Gene-Environment Interactions. JCO. 2000; 18(11): 2309-2315.
[95] Xi Y, Xu P. Global colorectal cancer burden in 2020 and projections to 2040. Translational oncology. 2021; 14(10): 101174.
[96] Seitz HK, Stickel F. Molecular mechanisms of alcohol-mediated carcinogenesis. Nature Reviews Cancer. 2007; 7(8): 599-612.
[97] Rossi M, Jahanzaib Anwar M, Usman A, Keshavarzian A, Bishehsari F. Colorectal cancer and alcohol consumption—populations to molecules. Cancers. 2018; 10(2): 38.
[98] McNabb S, Harrison TA, Albanes D, et al. Meta‐analysis of 16 studies of the association of alcohol with colorectal cancer. Intl Journal of Cancer. 2020; 146(3): 861-873.
[99] Thibault R, Dupertuis YM, Belabed L, Pichard C. Diet and physical activity: targets for action in cancer prevention. Rev Med Suisse. 2010; 6: 1046-1052.
[100] Choukran B, Debchi Bouthaina KM. Anti-cancer effects of certain medicinal plants: the case of colorectal cancer. Published online 2022. Accessed September 25, 2024.
[101] WHO, FAO. Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser. 2003; 916(i-viii): 1-149.
[102] Hitache Z, Al-Dalali S, Pei H, Cao X. Review of the Health Benefits of Cereals and Pseudocereals on Human Gut Microbiota. Food Bioprocess Technol. 2023; 16(11): 2382-2399.
[103] Champ M. Should we eat more whole grains? Nutrition and Dietetics Journals.2018; 53(1): 22-33.
[104] Aune D, Chan DS, Lau R, et al. Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies. Bmj. 2011; 343. Accessed October 9, 2025.
[105] Aglago EK, Huybrechts I, Murphy N, et al. Consumption of fish and long-chain n-3 polyunsaturated fatty acids is associated with reduced risk of colorectal cancer in a large European cohort. Clinical Gastroenterology and Hepatology. 2020; 18(3): 654-666.
[106] DiNicolantonio JJ, O'Keefe JH. Importance of maintaining a low omega-6/omega-3 ratio for reducing inflammation. Open Heart. 2018; 5(2): e000946.
[107] Hashim YZHY, Eng M, Gill CIR, McGlynn H, Rowland IR. Components of Olive Oil and Chemoprevention of Colorectal Cancer. Nutrition Reviews. 2005; 63(11): 374-386.
[108] Borzì AM, Biondi A, Basile F, Luca S, Vicari ESD, Vacante M. Olive oil effects on colorectal cancer. Nutrients. 2018; 11(1): 32.
[109] Sain A, Sahu S, Naskar D. Potential of olive oil and its phenolic compounds as therapeutic intervention against colorectal cancer: a comprehensive review. British Journal of Nutrition. 2022; 128(7): 1257-1273.
[110] Yin L, Grandi N, Raum E, Haug U, Arndt V, Brenner H. Meta‐analysis: longitudinal studies of serum vitamin D and colorectal cancer risk. Aliment Pharmacol Ther. 2009; 30(2): 113-125.
[111] Thorning TK, Raben A, Tholstrup T, Soedamah-Muthu SS, Givens I, Astrup A. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence. Food & Nutrition Research. 2016; 60(1): 32527.
[112] Lamprecht SA, Lipkin M. Chemoprevention of colon cancer by calcium, vitamin D and folate: molecular mechanisms. Nature reviews cancer. 2003; 3(8): 601-614.
[113] Klampfer L. Vitamin D and colon cancer. World journal of gastrointestinal oncology. 2014; 6(11): 430.
[114] Ma Y, Zhang P, Wang F, Yang J, Liu Z, Qin H. Association Between Vitamin D and Risk of Colorectal Cancer: A Systematic Review of Prospective Studies. JCO. 2011; 29(28): 3775-3782.
[115] Bassett JK, Severi G, Hodge AM, et al. Dietary Intake of B Vitamins and Methionine and Colorectal Cancer Risk. Nutrition and Cancer. 2013; 65(5): 659-667.
[116] Saeed RF, Naz S, Awan UA, Gul S, Subhan F, Saeed S. Micronutrients Importance in Cancer Prevention—Vitamins. In: Saeed RF, Shaheed S ul, eds. Nutrition and Dietary Interventions in Cancer. Springer Nature Switzerland; 2024: 119-144.
[117] Kim Y. Folate and colorectal cancer: An evidence‐based critical review. Molecular Nutrition Food Res. 2007; 51(3): 267-292.
[118] Yun J, Mullarky E, Lu C, et al. Vitamin C selectively kills KRAS and BRAF mutant colorectal cancer cells by targeting GAPDH. Science. 2015; 350(6266): 1391-1396.
[119] Yuan S, Carter P, Vithayathil M, et al. Genetically predicted circulating B vitamins in relation to digestive system cancers. Br J Cancer. 2021; 124(12): 1997-2003.
[120] Panprathip P, Petmitr S, Tungtrongchitr R, Kaewkungwal J, Kwanbunjan K. Low folate status, and MTHFR 677C> T and MTR 2756A> G polymorphisms associated with colorectal cancer risk in Thais: a case-control study. Nutrition Research. 2019; 72: 80-91.
[121] Kuiper C, Vissers MC. Ascorbate as a co-factor for Fe-and 2-oxoglutarate dependent dioxygenases: physiological activity in tumor growth and progression. Frontiers in oncology. 2014; 4: 359.
[122] Cenigaonandia-Campillo A, Serna-Blasco R, Gómez-Ocabo L, et al. Vitamin C activates pyruvate dehydrogenase (PDH) targeting the mitochondrial tricarboxylic acid (TCA) cycle in hypoxic KRAS mutant colon cancer. Theranostics. 2021; 11(8): 3595.
[123] Montagnani Marelli M, Marzagalli M, Fontana F, Raimondi M, Moretti RM, Limonta P. Anticancer properties of tocotrienols: A review of cellular mechanisms and molecular targets. Journal Cellular Physiology. 2019; 234(2): 1147-1164.
[124] Sowmya PRR, Ambedkar R, Lakshminarayana R. Role of Carotenoids on Oxidative Stress-Mediated Signaling in Cancer Cells. In: Chakraborti S, Ray BK, Roychoudhury S, eds. Handbook of Oxidative Stress in Cancer: Mechanistic Aspects. Springer Nature; 2022: 1407-1426.
[125] Rowles III JL, Erdman Jr JW. Carotenoids and their role in cancer prevention. Biochimica et Biophysica Acta (BBA)-Molecular and Cell Biology of Lipids. 2020; 1865(11): 158613.
[126] Bieri JG, Brown ED, Smith JC. Determination of Individual Carotenoids in Human Plasma by High Performance Liquid Chromatography. Journal of Liquid Chromatography. 1985; 8(3): 473-484.
[127] Lu MS, Fang YJ, Chen YM, et al. Higher intake of carotenoid is associated with a lower risk of colorectal cancer in Chinese adults: a case-control study. Eur J Nutr. 2015; 54(4): 619-628.
[128] Tang F, Shih C, Cheng L, Ho H, Chen H. Lycopene inhibits growth of human colon cancer cells via suppression of the Akt signaling pathway. Molecular Nutrition Food Res. 2008; 52(6): 646-654.
[129] Haghighatdoost F, Mohammadifard N, Sarrafzadegan N. Trace Minerals. In: Jafari SM, Rashidinejad A, Simal-Gandara J, eds. Handbook of Food Bioactive Ingredients: Properties and Applications. Springer International Publishing; 2023: 1021-1062.
[130] Cai X, Su Y, Ning J, Fan X, Shen M. Research on the Effect and Mechanism of Selenium on Colorectal Cancer Through TRIM32. Biol Trace Elem Res. Published online May 1, 2024.
[131] Sureda A, Capó X, Tejada S. Minerals (Namely Selenium) and Cancer. In: Jafari SM, Nabavi SM, Silva AS, eds. Nutraceuticals and Cancer Signaling: Clinical Aspects and Mode of Action. Springer International Publishing; 2021: 545-568.
[132] Benallal Z, Najdi A, Elmlili N. Nutrition et fonction immunitaire. Journal of Nursing and Biomedical Sciences. 2022; 1(1): 1.
[133] Wang J, Zhao H, Xu Z, Cheng X. Zinc dysregulation in cancers and its potential as a therapeutic target. Cancer biology & medicine. 2020; 17(3): 612-625.
[134] Skrajnowska D, Bobrowska-Korczak B. Role of zinc in immune system and anti-cancer defense mechanisms. Nutrients. 2019; 11(10): 2273.
[135] Wang Y, Pei P, Yang K, Guo L, Li Y. Copper in colorectal cancer: From copper‐related mechanisms to clinical cancer therapies. Clinical & Translational Med. 2024; 14(6): e1724.
[136] Zhang X, Walke GR, Horvath I, et al. Memo1 binds reduced copper ions, interacts with copper chaperone Atox1, and protects against copper-mediated redox activity in vitro. Proc Natl Acad Sci USA. 2022; 119(37): e2206905119.
[137] Grochowski C, Blicharska E, Baj J, et al. Serum iron, magnesium, copper, and manganese levels in alcoholism: a systematic review. Molecules. 2019; 24(7): 1361.
[138] Crichton RR, Pierre JL. Old iron, young copper: from Mars to Venus. Biometals. 2001; 14: 99-112.
[139] Phipps O, Brookes MJ, Al-Hassi HO. Iron deficiency, immunology, and colorectal cancer. Nutrition reviews. 2021; 79(1): 88-97.
[140] Estêvão D, Da Cruz-Ribeiro M, Cardoso AP, et al. Iron metabolism in colorectal cancer: a balancing act. Cell Oncol. 2023; 46(6): 1545-1558.
[141] Aksan A, Farrag K, Aksan S, Schroeder O, Stein J. Flipside of the coin: iron deficiency and colorectal cancer. Frontiers in immunology. 2021; 12: 635899.
[142] Zabłocka-Słowińska K, Grajeta H. The role of manganese in etiopathogenesis and prevention of selected diseases. Advances in Hygiene & Experimental Medicine/Postepy Higieny i Medycyny Doswiadczalnej. 2012; 66.
[143] Chen CS, Zhao Q, Wang J, et al. Enhanced anti-tumor effects achieved in a murine tumor model using combination therapy of recombinant human manganese superoxide dismutase and adriamycin. Biochemical and biophysical research communications. 2008; 370(4): 663-668.
[144] Leport J. Dynamics of Changing Dietary Patterns: The Case of Fish in Dakar. PhD Thesis. Université Toulouse le Mirail-Toulouse II; 2017. Accessed December 14, 2024.
[145] Popkin BM. The shift in stages of the nutrition transition in the developing world differs from past experiences! Public health nutrition. 2002; 5(1A): 205-214.
[146] Ntandou GD. Nutrition transition and cardiovascular disease risk factors in Benin: a study in the secondary town of Ouidah and its rural periphery. Published online 2010. Accessed December 14, 2024.
[147] World Bank. Placing Nutrition at the Heart of Development: A Strategy for Scaling Up Intervention - Overview. Montreal: St-Martin. Published online 2007. Accessed December 14, 2024.
Cite This Article
  • APA Style

    Novignon, D., Koffi, D., Kodjovi, S., Komlan, M. L., Tossavi, D., et al. (2026). Diet and Colorectal Cancer: A Comprehensive Systematic Review of Epidemiological Evidence. Science Journal of Public Health, 14(5), 235-252. https://doi.org/10.11648/j.sjph.20261405.13

    Copy | Download

    ACS Style

    Novignon, D.; Koffi, D.; Kodjovi, S.; Komlan, M. L.; Tossavi, D., et al. Diet and Colorectal Cancer: A Comprehensive Systematic Review of Epidemiological Evidence. Sci. J. Public Health 2026, 14(5), 235-252. doi: 10.11648/j.sjph.20261405.13

    Copy | Download

    AMA Style

    Novignon D, Koffi D, Kodjovi S, Komlan ML, Tossavi D, et al. Diet and Colorectal Cancer: A Comprehensive Systematic Review of Epidemiological Evidence. Sci J Public Health. 2026;14(5):235-252. doi: 10.11648/j.sjph.20261405.13

    Copy | Download

  • @article{10.11648/j.sjph.20261405.13,
      author = {Dandonougbo Novignon and Dandonougbo Koffi and Sossou Kodjovi and Mensah Labité Komlan and Dandonougbo Tossavi and Tabago Dissirama},
      title = {Diet and Colorectal Cancer: A Comprehensive Systematic Review of Epidemiological Evidence},
      journal = {Science Journal of Public Health},
      volume = {14},
      number = {5},
      pages = {235-252},
      doi = {10.11648/j.sjph.20261405.13},
      url = {https://doi.org/10.11648/j.sjph.20261405.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20261405.13},
      abstract = {Colorectal cancer (CRC) ranks among the most prevalent cancers worldwide, with lifestyle factors including diet playing a crucial role in its development and progression. This systematic review aims to synthesize current epidemiological evidence on the associations between dietary factors and CRC risk, following PRISMA 2020 guidelines. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library databases for articles published between January 2000 and December 2025. The search strategy combined terms related to colorectal cancer, dietary factors, and risk factors. Studies were included if they examined human populations, assessed dietary exposures, reported CRC outcomes, and were observational studies, interventional trials, systematic reviews, or meta-analyses. Two reviewers independently screened records, extracted data, and assessed quality using Newcastle-Ottawa Scale, Cochrane RoB 2.0, and AMSTAR-2 tools of 3,150 initially identified records, 90 studies met inclusion criteria and were included in the systematic synthesis. The reviewed evidence indicates that high consumption of red and processed meats (RR: +12-18% per 100g/day), saturated fats, ultra-processed foods, alcohol (dose-dependent), and tobacco (RR: 2-3× vs. non-smokers) is associated with increased CRC risk. Conversely, diets rich in fiber, fruits, vegetables, whole grains, fish, olive oil, dairy products, and specific micronutrients (vitamins D, B-group, C, E, selenium, zinc) show inverse associations with CRC risk (20-50% risk reduction). Epidemiological studies suggest that modifiable lifestyle factors may influence CRC risk by approximately 60-70%, though these estimates derive primarily from observational data with moderate to high heterogeneity. This systematic review highlights the potential for CRC prevention through dietary modifications. However, due to the observational nature of most available evidence, further well-designed prospective studies and randomized controlled trials are needed to establish causal relationships. The findings should be interpreted as associations rather than causal effects.},
     year = {2026}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Diet and Colorectal Cancer: A Comprehensive Systematic Review of Epidemiological Evidence
    AU  - Dandonougbo Novignon
    AU  - Dandonougbo Koffi
    AU  - Sossou Kodjovi
    AU  - Mensah Labité Komlan
    AU  - Dandonougbo Tossavi
    AU  - Tabago Dissirama
    Y1  - 2026/10/29
    PY  - 2026
    N1  - https://doi.org/10.11648/j.sjph.20261405.13
    DO  - 10.11648/j.sjph.20261405.13
    T2  - Science Journal of Public Health
    JF  - Science Journal of Public Health
    JO  - Science Journal of Public Health
    SP  - 235
    EP  - 252
    PB  - Science Publishing Group
    SN  - 2328-7950
    UR  - https://doi.org/10.11648/j.sjph.20261405.13
    AB  - Colorectal cancer (CRC) ranks among the most prevalent cancers worldwide, with lifestyle factors including diet playing a crucial role in its development and progression. This systematic review aims to synthesize current epidemiological evidence on the associations between dietary factors and CRC risk, following PRISMA 2020 guidelines. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library databases for articles published between January 2000 and December 2025. The search strategy combined terms related to colorectal cancer, dietary factors, and risk factors. Studies were included if they examined human populations, assessed dietary exposures, reported CRC outcomes, and were observational studies, interventional trials, systematic reviews, or meta-analyses. Two reviewers independently screened records, extracted data, and assessed quality using Newcastle-Ottawa Scale, Cochrane RoB 2.0, and AMSTAR-2 tools of 3,150 initially identified records, 90 studies met inclusion criteria and were included in the systematic synthesis. The reviewed evidence indicates that high consumption of red and processed meats (RR: +12-18% per 100g/day), saturated fats, ultra-processed foods, alcohol (dose-dependent), and tobacco (RR: 2-3× vs. non-smokers) is associated with increased CRC risk. Conversely, diets rich in fiber, fruits, vegetables, whole grains, fish, olive oil, dairy products, and specific micronutrients (vitamins D, B-group, C, E, selenium, zinc) show inverse associations with CRC risk (20-50% risk reduction). Epidemiological studies suggest that modifiable lifestyle factors may influence CRC risk by approximately 60-70%, though these estimates derive primarily from observational data with moderate to high heterogeneity. This systematic review highlights the potential for CRC prevention through dietary modifications. However, due to the observational nature of most available evidence, further well-designed prospective studies and randomized controlled trials are needed to establish causal relationships. The findings should be interpreted as associations rather than causal effects.
    VL  - 14
    IS  - 5
    ER  - 

    Copy | Download

Author Information
  • Sections