Objective To examine the association between consumption of ultra-processed foods and risk of colorectal cancer among men and women from three large prospective cohorts. Design Prospective cohort study with dietary intake assessed every four years using food frequency questionnaires. Setting Three large US cohorts. Participants Men (n= 46 341) from the Health Professionals Follow-up Study (1986-2014) and women (n=159 907) from the Nurses’ Health Study (1986-2014; n=67 425) and the Nurses’ Health Study II (1991-2015; n=92 482) with valid dietary intake measurement and no cancer diagnosis at baseline. Main outcome measure Association between ultra-processed food consumption and risk of colorectal cancer, estimated using time varying Cox proportional hazards regression models adjusted for potential confounding factors. Results 3216 cases of colorectal cancer (men, n=1294; women, n=1922) were documented during the 24-28 years of follow-up. Compared with those in the lowest fifth of ultra-processed food consumption, men in the highest fifth of consumption had a 29% higher risk of developing colorectal cancer (hazard ratio for highest versus lowest fifth 1.29, 95% confidence interval 1.08 to 1.53; P for trend=0.01), and the positive association was limited to distal colon cancer (72% increased risk; hazard ratio 1.72, 1.24 to 2.37; P for trend<0.001). These associations remained significant after further adjustment for body mass index or indicators of nutritional quality of the diet (that is, western dietary pattern or dietary quality score). No association was observed between overall ultra-processed food consumption and risk of colorectal cancer among women. Among subgroups of ultra-processed foods, higher consumption of meat/poultry/seafood based ready-to-eat products (hazard ratio for highest versus lowest fifth 1.44, 1.20 to 1.73; P for trend<0.001) and sugar sweetened beverages (1.21, 1.01 to 1.44; P for trend=0.013) among men and ready-to-eat/heat mixed dishes among women (1.17, 1.01 to 1.36; P for trend=0.02) was associated with increased risk of colorectal cancer; yogurt and dairy based desserts were negatively associated with the risk of colorectal cancer among women (hazard ratio 0.83, 0.71 to 0.97; P for trend=0.002). Conclusions In the three large prospective cohorts, high consumption of total ultra-processed foods in men and certain subgroups of ultra-processed foods in men and women was associated with an increased risk of colorectal cancer. Further studies are needed to better understand the potential attributes of ultra-processed foods that contribute to colorectal carcinogenesis. No additional data available.

中文翻译：

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超加工食品消费与男性和女性结直肠癌风险的关联：来自美国三项前瞻性队列研究的结果

目的 从三个大型前瞻性队列研究男性和女性的超加工食品消费与结直肠癌风险之间的关系。设计前瞻性队列研究，使用食物频率问卷每四年评估一次膳食摄入量。设置三个大型美国队列。参与者来自卫生专业人员随访研究（1986-2014）的男性（n = 46 341）和来自护士健康研究（1986-2014；n = 67 425）和护士健康的女性（n = 159 907）研究 II (1991-2015; n=92 482) 进行了有效的饮食摄入测量，基线时没有癌症诊断。主要结果测量 超加工食品消费与结直肠癌风险之间的关联，使用针对潜在混杂因素调整的时变 Cox 比例风险回归模型进行估计。结果 在 24-28 年的随访中记录了 3216 例结直肠癌（男性，n=1294；女性，n=1922）。与超加工食品消费量最低的五分之一相比，消费量最高的五分之一的男性患结直肠癌的风险高出 29%（最高与最低五分之一的风险比为 1.29，95% 置信区间为 1.08 至 1.53；P趋势 = 0.01），正相关仅限于远端结肠癌（风险增加 72%；风险比 1.72、1.24 至 2.37；趋势 P<0.001）。在进一步调整体重指数或饮食营养质量指标（即西方饮食模式或饮食质量评分）后，这些关联仍然显着。未观察到整体超加工食品消费与女性患结直肠癌的风险之间存在关联。在超加工食品亚组中，肉类/家禽/海鲜类即食产品的消费量较高（最高与最低五分之一的风险比为 1.44，1.20 至 1.73；趋势 P<0.001）和含糖饮料（1.21， 1.01 至 1.44；趋势 P = 0.013）在男性和女性中的即食/加热混合菜肴（1.17, 1.01 至 1.36；趋势 P = 0.02）与结直肠癌风险增加相关；酸奶和乳制品甜点与女性患结直肠癌的风险呈负相关（风险比为 0.83、0.71 至 0.97；趋势 P = 0.002）。结论 在三个大型前瞻性队列中，男性和女性超加工食品的某些亚组总超加工食品的高消费与结直肠癌风险增加相关。需要进一步研究以更好地了解导致结直肠癌发生的超加工食品的潜在属性。没有可用的额外数据。