Colorectal cancer

Our analysis of worldwide research on colorectal cancer

As part of the Continuous Update Project (CUP) – our ongoing programme to analyse global research on how diet, nutrition, physical activity and weight affect cancer risk and survival – we have analysed worldwide research to produce our report on colorectal cancer

Published in September 2017, the report is the most rigorous, systematic, global analysis of the scientific research currently available on diet, weight, physical activity and colorectal cancer, and which of these factors increase or decrease the risk of developing the disease.

For the report, the global scientific research on diet, nutrition, physical activity and colorectal cancer was gathered and analysed by a research team at Imperial College London, and then independently assessed by a panel of leading international scientists.

The report reviewed evidence from 99 studies from around the world. The studies examined more than 29 million adults and over 247,000 cases of colorectal cancer.

The report updates the colorectal cancer section of our 2007 Second Expert Report and the 2011 CUP Colorectal Cancer Report.

Key findings

There is strong evidence that:

  • being physically active decreases the risk of colon cancer
  • consuming wholegrains decreases the risk of colorectal cancer
  • consuming foods containing dietary fibre decreases the risk of colorectal cancer
  • consuming dairy products decreases the risk of colorectal cancer
  • taking calcium supplements decreases the risk of colorectal cancer
  • consuming red meat increases the risk of colorectal cancer
  • consuming processed meat increases the risk of colorectal cancer
  • consuming approximately two or more alcoholic drinks per day increases the risk of colorectal cancer
  • being overweight or obese increases the risk of colorectal cancer
  • being tall increases the risk of colorectal cancer

Much of the new evidence in this report was on wholegrains, vitamin D, foods containing vitamin C, fish, multivitamin supplements, and low intakes of fruit and non-starchy vegetables.

Recommendations

To reduce the risk of developing colorectal cancer, follow our Cancer Prevention Recommendations. Our ten Cancer Prevention Recommendations are for preventing cancer in general and include maintaining a healthy weight, being physically active, eating a healthy diet and limiting alcohol consumption (if consumed at all).

Read our blog on the positive steps you can take to reduce colorectal cancer risk and also our frequently asked questions

A more detailed overview of the findings is provided in the Executive Summary of the report.

Published findings in peer-reviewed journals

Selected findings from the colon and rectum cancer CUP update have been published in peer-reviewed journals. Details of the papers and links to the abstract in PubMed are below:

Adult weight gain and colorectal adenomas – a systematic review and meta-analysis. Schlesinger S, Aleksandrova K, Abar L, Vieira AR, Vingeliene S, Polemiti E, Stevens CAT, Greenwood DC, Chan DSM, Aune D & Norat T. Ann Oncol. 2017;28(6): 1217-1229. Abstract.

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. Vieira AR, Abar L, Chan DSM, Vingeliene S, Polemiti E, Stevens C, Greenwood D & Norat T. Ann Oncol. 2017; 28(8): 1788-1802. Abstract.

Red and processed meat intake and risk of colorectal adenomas: a systematic review and meta-analysis of epidemiological studies.
 Aune D, Chan DS, Vieira AR, Navarro Rosenblatt DA, Vieira R, Greenwood DC, Kampman E & Norat T. Cancer Causes Control. 2013; 24(4): 611-27. Abstract.

Carbohydrates, glycaemic index, glycaemic load, and colorectal cancer risk: a systematic review and meta-analysis of cohort studies. 
Aune D, Chan DS, Lau R, Vieira R, Greenwood DC, Kampman E & Norat T. 
Cancer Causes Control. 2012; 23(4): 521-535. Abstract.

Recent evidence for colorectal cancer prevention through healthy food, nutrition, and physical activity: implications for recommendations. Perera PS, Thompson RL & Wiseman MJ.
 Curr Nutr Rep. 2012 DOI 10.1007/s13668-011-0006-7. Abstract.

Dairy products and colorectal cancer risk: a systematic review and meta-analysis of cohort studies. 
Aune D, Lau R, Chan DS, Vieira R, Greenwood DC, Kampman E & Norat T. 
Ann Oncol. 2012; 23(1): 37-45. Abstract.

Meta-analyses of vitamin D intake, 25-hydroxyvitamin D status, vitamin D receptor polymorphisms, and colorectal cancer risk. 
Touvier M, Chan DS, Lau R, Aune D, Vieira R, Greenwood DC, Kampman E, Riboli E, Hercberg S & Norat T. 
Cancer Epidemiol Biomakers Prev. 2011; 20(5): 1003-16. Abstract.

Nonlinear reduction in risk for colorectal cancer by fruit and vegetable intake based on meta-analysis of prospective studies. 
Aune D, Lau R, Chan DS, Vieira R, Greenwood DC, Kampman E & Norat T. 
Gastroenterology 2011; 141(1): 106-18. Abstract.

Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. 
Chan DS, Lau R, Aune D, Vieira R, Greenwood DC, Kampman E & Norat T. 
PLoS ONE. 2011; 6: e20456. Abstract.

Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective cohort studies. 
Aune D, Chan DS, Lau R, Vieira R, Greenwood DC, Kampman E & Norat T. 
BMJ 2011; 343:d6617 Nov 10. Abstract.