ArticleJournal of the National Cancer Institute2021
Comprehensive Assessment of Diet Quality and Risk of Precursors of Early-Onset Colorectal Cancer.
Article in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05732623 (Diet obEsity sMoking Epigenetics geneTics biomaRkers Physical Activity), which is not on this map. Cited by 92 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diet obEsity sMoking Epigenetics geneTics biomaRkers Physical Activity: An International Multicenter Case-control Study on Endogenous and Exogenous Risk Factors in Early-onset Colorectal Cancer
Who cites it
92 citing papers in PubMed, 7 syntheses or guidelines pooled it, 139 citations in OpenAlex.
- Colorectal cancer treatment assisted by robotic platforms - a systematic review.Journal of robotic surgery · 2026Pooled it
- Association between adhering to a dietary approach to stop hypertension and risk of colorectal cancer: a systematic review and meta-analysis.BMC gastroenterology · 2025Pooled it
- Adherence to the Mediterranean diet and its protective effects against colorectal cancer: a meta-analysis of 26 studies with 2,217,404 participants.GeroScience · 2025Pooled it
- Delphi Initiative for Early-Onset Colorectal Cancer (DIRECt) International Management Guidelines.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Guideline
- A risk scoring system to predict the individual incidence of early-onset colorectal cancer.BMC cancer · 2022Pooled it
- Diet as a Risk Factor for Early-Onset Colorectal Adenoma and Carcinoma: A Systematic Review.Frontiers in nutrition · 2022Pooled it
- Association between Dietary Fibre Intake and Colorectal Adenoma: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2021Pooled it
- Shaping the future of early-onset colorectal cancer prevention.Nature reviews. Cancer · 2026Review
- Modifiable risk factors contributing to the rising incidence of early-onset colorectal cancer in the United States over three decades: a Global Burden of Disease analysis.Journal of gastrointestinal oncology · 2026Article
- Racial/Ethnic Disparities in Early-Onset Colorectal Cancer Outcomes.Journal of racial and ethnic health disparities · 2026Article
- The EduNutriCRC Questionnaire: A Pilot Knowledge-Attitudes-Practices Study on Nutritional Prevention of Colorectal Cancer in Romanian Adults.Nutrients · 2026Article
- Early-onset colorectal cancer: a comprehensive review reframing hypotheses and defining research priorities.International journal of colorectal disease · 2026Review
- Early-Onset Digestive System Cancers: Risk Factors and Clinicopathological and Molecular Features Across Organ Sites.Cancer science · 2026Review
- Exploring the role of marital status on survival and stage at diagnosis in early-onset colorectal cancer by race/ethnicity.Scientific reports · 2026Article
- Why Is Colorectal Cancer Occurring Earlier? Metabolic Dysfunction, Underrecognized Carcinogens, and Emerging Controversies.Current obesity reports · 2026Review
- Clinicopathological Features of Endoscopically Resected Early-Onset Colorectal Neoplasia Compared with Later-Onset Cases.Cancers · 2026Article
- Gut microbiome in colorectal cancer: recent advances and clinical implications.Annals of coloproctology · 2026Review
- The Epidemiology of colorectal cancer in Guangzhou, China: A cross-sectional and age-period-cohort study.PLOS global public health · 2026Article
- Epidemiological trends and risk factors of early-onset colorectal cancer in the founding BRICS countries, 1990-2023, with projections to 2050.Frontiers in oncology · 2026Article
- Characterization of the mutational landscapes in Japanese patients with early-onset colorectal cancer from comprehensive genomic profiling data.International journal of clinical oncology · 2025Article
32 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundThe role of poor diet quality in the rising incidence of colorectal cancer (CRC) diagnosed younger than age 50 years has not been explored. Based on molecular features of early-onset CRC, early-onset adenomas are emerging surrogate endpoints.
methodsIn a prospective cohort study (Nurses' Health Study II), we evaluated 2 empirical dietary patterns (Western and prudent) and 3 recommendation-based indexes (Dietary Approaches to Stop Hypertension [DASH], Alternative Mediterranean Diet [AMED], and Alternative Healthy Eating Index [AHEI]-2010) with risk of early-onset adenoma overall and by malignant potential (high-risk: ≥1 cm, tubulovillous or villous histology, high-grade dysplasia, or ≥3 adenomas), among 29 474 women with 1 or more lower endoscopy before age 50 years (1991-2011). Multivariable logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
resultsWe documented 1157 early-onset adenomas with 375 at high risk. Western diet was positively associated, whereas prudent diet, DASH, AMED, and AHEI-2010 were inversely associated with risk of early-onset adenoma. The associations were largely confined to high-risk adenomas (the highest vs lowest quintile: Western, OR = 1.67, 95% CI = 1.18 to 2.37; prudent, OR = 0.69, 95% CI = 0.48 to 0.98; DASH, OR = 0.65, 95% CI = 0.45 to 0.93; AMED, OR = 0.55, 95% CI = 0.38 to 0.79; AHEI-2010, OR = 0.71, 95% CI = 0.51 to 1.01; all Ptrend ≤ .03), driven by those identified in the distal colon and rectum (all Ptrend ≤ .04, except AMED: Ptrend = .14).
conclusionPoor diet quality was associated with an increased risk of early-onset distal and rectal adenomas of high malignant potential. These findings provide preliminary but strong support to the role of diet in early-onset CRC.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.