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A study published in Jama Oncology said that of 29,105 females (below 50 years) who underwent lower endoscopy in a long-term study, those with the highest consumption of ultra-processed foods (UPF) intake had a statistically significant 45% higher odds of early-onset colorectal conventional adenomas compared with the lowest quintile.
The results of this study suggest that reducing ultra-processed foods intake may be an effective dietary strategy to prevent early-onset of colorectal tumorigenesis.
Colorectal tumorigenesis is the process of cancer developing in the colon and rectum, driven by a step-by-step accumulation of genetic and epigenetic changes in the lining’s epithelial cells
Early-onset colorectal cancer (EOCRC) (diagnosed age below 50 years) incidence is increasing globally, in parallel with increased consumption of ultra-processed foods (UPFs). The role of UPFs in early-onset colorectal neoplasia remains underexplored.
This prospective cohort study included participants of the Nurses’ Health Study II, an ongoing US prospective cohort of female registered nurses established in 1989. Participants were followed up from June 1, 1991, through June 1, 2015. Data were analyzed from October 2024 to July 2025.
UPF intake, was derived from food-frequency questionnaires administered every 4 years and classified using the Nova system. Of the nurses enrolled, those who had completed the baseline 1991 food-frequency questionnaire, undergone at least 1 lower endoscopy before age 50 years after baseline, had no history of cancer (except for nonmelanoma skin cancer) before endoscopy, and no colorectal polyp or inflammatory bowel disease were included.
Among the 29,105 female participants with over 24 years of follow-up, 1,189 cases were documented of early-onset conventional adenomas and 1,598 serrated lesions. UPFs provided 34.8% of total daily calories. Participants with higher UPF intake had an increased risk of early-onset conventional adenomas. Findings were consistent after further adjustment for body mass index, type 2 diabetes, dietary factors (fiber, folate, calcium, and vitamin D), and Alternative Healthy Eating Index–2010 score.
In this study, higher UPF intake was associated with increased risk of early-onset colorectal conventional adenomas. These data highlight the important role of UPFs in early-onset colorectal tumorigenesis and support improving dietary quality as a strategy to mitigate the increasing burden of EOCRC.
