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@ARTICLE{AlNahas:298612,
author = {A. Al Nahas and S. Yammine Ghantous and F. Morales Berstein
and E. K. Cakmak and C. Biessy and G. Nicolas and N.
Kliemann and J. B. Lopez and I. Jacobs and E. M.
Gonzalez-Gil and M. Cairat and M. G. M. Pinho and R.
Bertazzi Levy and F. Rauber and E. P. Vamos and K. Chang and
C. Millett and M. Touvier and E. Kesse-Guyot and G. Severi
and C. Marques and M. Hajji and A. Macciotta and G. Masala
and M. Fordellone and C. Agnoli and P. Amiano and M. Guevara
and A. Tjønneland and C. Kyrø and J. W. G. Derksen and K.
C. Smit and M. B. Schulze and F. Jannasch and R. Kaaks$^*$
and V. Katzke$^*$ and T. Braaten and M. Brustad and G. Skeie
and R. Harewood and A. Heath and P. Vineis and E. Weiderpass
and P. Ferrari and M. J. Gunter and I. Huybrechts},
title = {{A}ssociations between degree of food processing and
colorectal cancer risk in a large-scale {E}uropean cohort.},
journal = {International journal of cancer},
volume = {157},
number = {2},
issn = {0020-7136},
address = {Bognor Regis},
publisher = {Wiley-Liss},
reportid = {DKFZ-2025-00312},
pages = {260-276},
year = {2025},
note = {Volume157, Issue2, 15 July 2025, Pages 260-276},
abstract = {Industrial food processing has been linked to various
health outcomes including cancer. To examine associations
between the degree of food processing and risk of colorectal
cancer (CRC) and its sub-sites, data from the European
Prospective Investigation into Cancer (EPIC) including 6155
incident CRC cases (n = 450,111 participants), were
analyzed. Dietary intakes were assessed using baseline food
frequency questionnaires. Foods were classified into
culinary ingredients, unprocessed, processed (PFs), and
ultra-processed foods (UPFs) according to the Nova
classification. Cox proportional hazards models, adjusted
for established CRC risk factors, were used to estimate
hazard ratios (HRs) and $95\%$ confidence intervals $(95\%$
CIs) associated with a $10\%$ increase in proportion of
consumption $(\%g/d)$ of each Nova group. Substitution
analysis examined the effect of replacing UPFs and PFs with
unprocessed foods on CRC risk. A $10\%$ increase in
proportion of UPFs was associated with $6\%$ higher CRC risk
$(95\%$ CI:1.02-1.10). A positive association was also found
between PFs and CRC risk (HR per $10\%$ increase: 1.10
$[95\%$ CI, 1.05-1.15]). Conversely, unprocessed food
consumption was inversely associated with CRC risk (HR per
$10\%$ increase: $0.93[95\%$ CI, 0.90-0.95]). Substitution
of $10\%$ of the overall proportion of the diet comprising
UPFs or PFs with $10\%$ unprocessed foods was associated
with a decreased risk of CRC (HRUPFs: 0.94 $[95\%$ CI,
0.90-0.97]; HRPFs: 0.90 $[95\%$ CI, 0.86-0.94]). In
conclusion, UPF was positively associated with CRC risk
while diets richer in unprocessed foods were associated with
lower CRC risk. Further studies are needed to understand the
mechanisms by which food processing affects CRC risk.},
keywords = {Colorectal cancer (Other) / EPIC (Other) / Nova
classification (Other) / UPFs (Other) / obesity (Other)},
cin = {C020},
ddc = {610},
cid = {I:(DE-He78)C020-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39921517},
doi = {DOI:10.1002/ijc.35361},
url = {https://inrepo02.dkfz.de/record/298612},
}