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.

中文翻译：

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诊断后饮食因素、补充剂使用和结直肠癌预后：全球癌症更新计划 (CUP Global) 系统文献综述和荟萃分析

饮食在结直肠癌预后中的作用尚不清楚，也缺乏具体的生活方式建议。我们在 PubMed 和 Embase 中检索了从成立到 2022 年 2 月 28 日期间关于诊断后饮食因素、补充剂使用和结直肠癌生存结果的随机对照试验 (RCT) 和纵向观察研究。随机效应剂量反应荟萃分析是在以下时间进行的：至少三项研究提供了足够的信息。证据由 CUP 全球癌症生存独立专家委员会和专家小组进行解释和分级。纳入了 5 项随机对照试验和 35 项观察性研究（30,242 例病例，超过 8700 例全因死亡和 2100 例结直肠癌死亡，3700 例进展、复发或无病事件）。荟萃分析，包括 3-10 项观察性研究，针对：全谷物、坚果/花生、红肉和加工肉类、乳制品、含糖饮料、人工甜味饮料、咖啡、酒精、膳食血糖​​负荷/指数、胰岛素负荷/index、海洋 omega-3 多不饱和脂肪酸、补充钙、循环 25-羟基维生素 D (25[OH]D) 和全因死亡率；酒精、补充钙、循环 25(OH)D 和结直肠癌特异性死亡率；以及循环 25(OH)D 和复发/无病生存。总体证据被评为“有限”。健康饮食和/或生活方式模式（包括植物性食品的饮食）、全谷物、全麦咖啡、含咖啡因或不含咖啡因的咖啡与全因死亡率之间呈负相关，而不健康饮食模式、含糖饮料和所有咖啡因之间呈正相关。死亡率提供了“有限的暗示性”证据。所有其他暴露-结果关联都提供了“有限——无结论”的证据。还需要进行良好的队列研究和精心设计的随机对照试验，为结直肠癌幸存者制定具体的生活方式建议。