Associations between degree of industrial food processing and colorectal cancer risk in a large European cohort

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), data from the European Prospective Investigation into Cancer (EPIC; n=450,111 participants) were analyzed. Dietary intakes werd assessed using baseline food frequency questionnaires. Foods were classified into ingredients, unprocessed, processed (PFs) and ultraprocessed foods (UPFs) according to the NOVA classification. During follow-up, incident CRC was diagnosed in 6155 EPIC participants. Increase in proportion of UPFs and PFs in the diet was associated with increased CRC risk, while increase in the proportion of unprocessed foods in the diet was associated with decreased CRC risk. Substitution of 10% of the overall proportion of the diet comprising UPFs or PFs with 10% unprocessed foods was associated with decreased risk of CRC (UPFs: HR 0.94; 95% CI 0.90-0.97; PFs: HR 0.90; 95% CI 0.86-0.94). The authors conclude that UPFs and PFs in the diet were associated with higher CRC risk, whereas unprocessed foods were associated with lower CRC risk.