ArticleThe Lancet. Planetary health2023
Food processing and cancer risk in Europe: results from the prospective EPIC cohort study.
Article in The Lancet. Planetary health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 62 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
62 citing papers in PubMed, 3 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Ultra-processed food intake and risk of digestive system cancers: a systematic review and dose-response meta-analysis.Frontiers in nutrition · 2026Pooled it
- Association between ultra-processed food consumption and risk of breast cancer: a systematic review and dose-response meta-analysis of observational studies.Frontiers in nutrition · 2023Pooled it
- Ultra-processed food consumption and increased risk of metabolic syndrome: a systematic review and meta-analysis of observational studies.Frontiers in nutrition · 2023Pooled it
- Healthy Eating and Active Lifestyle after Bowel Cancer (HEAL ABC)-feasibility randomised controlled trial.European journal of clinical nutrition · 2024Trial
- Isocaloric replacement of ultraprocessed foods was associated with greater weight loss in the POUNDS Lost trial.Obesity (Silver Spring, Md.) · 2024Trial
- Associations of food processing and dietary risk factors with colorectal cancer incidence in the NIH-AARP Diet and Health Study: A cohort study.PLoS medicine · 2026Article
- Ultra-processed food intake and risk of renal cell carcinoma in the NIH-AARP Diet and health study: a prospective cohort analysis.Lancet regional health. Americas · 2026Article
- Ultraprocessed food intake and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study.Journal of the National Cancer Institute · 2026Article
- Rejecting Health as a Justification for Junk Food Taxes.Journal of bioethical inquiry · 2026Article
- Ultra-processed Foods and Gastrointestinal Cancer: Epidemiologic Evidence, Mechanistic Pathways, and Clinical Implications.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Review
- Adherence to planetary health diet and breast cancer risk: insights from a large case-control study in a low-and middle-income country setting.BMC public health · 2026Article
- Review
- Assessing the role of ultra-processed foods in colorectal cancer incidence: insights from the EPIC cohort.BMC public health · 2026Article
- Understandings of ultra-processed foods among adults with responsibility for household food activities in the United Kingdom: a qualitative study.BMC global and public health · 2026Article
- Ultra processed food consumption and nutrients adequacy among cancer survivors in Lebanon.BMC public health · 2026Article
- Adherence to World Cancer Research Fund and the American Institute for Cancer Research cancer prevention recommendations and reduction in breast cancer risk: results of a large-scale case-control study in Morocco.The British journal of nutrition · 2026Article
- Ultra-Processed Food Consumption, Mental Health, and Quality of Life in Adults: A Systematic Review Protocol.Health science reports · 2026Article
- Post-diagnostic ultra-processed food exposure in gastrointestinal cancers: scoping review with narrative synthesis and clinical implications.Frontiers in nutrition · 2026Review
- Assessing the Role of Lifestyle in Modulating Serum IGF-1 and Association with Breast Cancer Risk among Palestinian Women in the Gaza Strip: A Case-Control Study.Asian Pacific journal of cancer prevention : APJCP · 2026Article
- Ultra-processed food consumption and risk of oesophagus, stomach, and pancreatic cancers: a multi case-control study.Frontiers in nutrition · 2026Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
33 authors at 18 institutions in 10 countries.
Funding
Abstract
backgroundFood processing has been hypothesised to play a role in cancer development; however, data from large-scale epidemiological studies are scarce. This study investigated the association between dietary intake according to amount of food processing and risk of cancer at 25 anatomical sites using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study.
methodsThis study used data from the prospective EPIC cohort study, which recruited participants between March 18, 1991, and July 2, 2001, from 23 centres in ten European countries. Participant eligibility within each cohort was based on geographical or administrative boundaries. Participants were excluded if they had a cancer diagnosis before recruitment, had missing information for the NOVA food processing classification, or were within the top and bottom 1% for ratio of energy intake to energy requirement. Validated dietary questionnaires were used to obtain information on food and drink consumption. Participants with cancer were identified using cancer registries or during follow-up from a combination of sources, including cancer and pathology centres, health insurance records, and active follow-up of participants. We performed a substitution analysis to assess the effect of replacing 10% of processed foods and ultra-processed foods with 10% of minimally processed foods on cancer risk at 25 anatomical sites using Cox proportional hazard models.
findings521 324 participants were recruited into EPIC, and 450 111 were included in this analysis (318 686 [70·8%] participants were female individuals and 131 425 [29·2%] were male individuals). In a multivariate model adjusted for sex, smoking, education, physical activity, height, and diabetes, a substitution of 10% of processed foods with an equal amount of minimally processed foods was associated with reduced risk of overall cancer (hazard ratio 0·96, 95% CI 0·95-0·97), head and neck cancers (0·80, 0·75-0·85), oesophageal squamous cell carcinoma (0·57, 0·51-0·64), colon cancer (0·88, 0·85-0·92), rectal cancer (0·90, 0·85-0·94), hepatocellular carcinoma (0·77, 0·68-0·87), and postmenopausal breast cancer (0·93, 0·90-0·97). The substitution of 10% of ultra-processed foods with 10% of minimally processed foods was associated with a reduced risk of head and neck cancers (0·80, 0·74-0·88), colon cancer (0·93, 0·89-0·97), and hepatocellular carcinoma (0·73, 0·62-0·86). Most of these associations remained significant when models were additionally adjusted for BMI, alcohol and dietary intake, and quality.
interpretationThis study suggests that the replacement of processed and ultra-processed foods and drinks with an equal amount of minimally processed foods might reduce the risk of various cancer types.
fundingCancer Research UK, l'Institut National du Cancer, and World Cancer Research Fund International.
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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.