Observational studyGastroenterology2021
The Sulfur Microbial Diet Is Associated With Increased Risk of Early-Onset Colorectal Cancer Precursors.
Observational study in Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
67 citing papers in PubMed, 1 synthesis or guideline pooled it, 87 citations in OpenAlex.
- Diet as a Risk Factor for Early-Onset Colorectal Adenoma and Carcinoma: A Systematic Review.Frontiers in nutrition · 2022Pooled it
- Gut microbiota-derived metabolites as context-dependent modulators of Nrf2 signaling in inflammation-driven carcinogenesis.Gut microbes · 2026Review
- Article
- Sulfide dynamics at the gut-microbiota interface: diet, oxygen and redox interplay.Gut microbes · 2026Review
- Colorectal cancer landscape from gut microbiota: Insights into mutations, epigenetic dysregulation, and immune microenvironment alterations.Virulence · 2026Review
- Shaping the future of early-onset colorectal cancer prevention.Nature reviews. Cancer · 2026Review
- Review
- Comment on "Incidental Colorectal Adenomas in Adolescents: Clinical Management, Genetic Evaluation, and Surveillance".Journal of gastroenterology and hepatology · 2026Article
- Emerging trends in the global burden of colorectal cancer.Nature reviews. Clinical oncology · 2026Review
- Association of the sulfur microbial diet with metabolic profile, gut-related biomarkers, and adiposity indicators in adults with overweight and obesity.Scientific reports · 2026Article
- Divergent Colorectal Cancer Risks Following Metabolic Bariatric Surgery: Anatomical Remodeling and the Genotoxic Microenvironment.Obesity surgery · 2026Review
- Dietary sulfur amino acids enhance anti-tumor immunity in colon cancer via an NKT cell-XCL1-cDC1 circuit.Immunity · 2026Article
- Sulfur microbial diet, genetical predisposition, and the risk of chronic kidney disease: a cohort study.European journal of clinical nutrition · 2026Article
- Association Between the Dietary Index for Gut Microbiota (DI-GM) and Colorectal Cancer in the PLCO Cohort.Nutrients · 2026Article
- Association of Sulfur Microbial Diet and the Risk of Lung Cancer in Women.International journal of women's health · 2026Article
- A review of dietary patterns and the colorectal polyp-to-carcinoma sequence: polyp occurrence, polyp recurrence, and colorectal cancer.Frontiers in nutrition · 2026Review
- Gut microbiota-innate immune crosstalk in the initiation and progression of CRC: mechanisms and therapeutic potential.Frontiers in immunology · 2026Review
- Article
- Article
- Pooled analysis of 3,741 stool metagenomes from 18 cohorts for cross-stage and strain-level reproducible microbial biomarkers of colorectal cancer.Nature medicine · 2025Article
7 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors at 5 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsDiet may contribute to the increasing incidence of colorectal cancer (CRC) before age 50 (early-onset CRC). Microbial metabolism of dietary sulfur produces hydrogen sulfide (H
methodsWe evaluated long-term adherence to the sulfur microbial diet, a dietary index defined a priori based on increased abundance of 43 bacterial species involved with sulfur metabolism, with risk of CRC precursors among 59,013 individuals who underwent lower endoscopy in the Nurses' Health Study II (1991-2015), a prospective cohort study with dietary assessment every 4 years through validated food frequency questionnaires and an assessment of dietary intake during adolescence in 1998. The sulfur microbial diet was characterized by intake high in processed meats, foods previously linked to CRC development, and low in mixed vegetables and legumes. Multivariable logistic regression for clustered data was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
resultsWe documented 2911 cases of early-onset adenoma. After adjusting for established risk factors, higher sulfur microbial diet scores were associated with increased risk for early-onset adenomas (OR
conclusionsOur findings in a cohort of young women support a role for dietary interactions with gut sulfur-metabolizing bacteria in early-onset colorectal carcinogenesis, possibly beginning in adolescence.
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Registered trials
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.