Diet-wide analyses for risk of colorectal cancer: prospective study of 12,251 incident cases among 542,778 women in the UK
Nature Communications volume 16, Article number: 375 (2025 ) Cite this article
Uncertainty remains regarding the role of diet in colorectal cancer development. We examined associations of 97 dietary factors with colorectal cancer risk in 542,778 Million Women Study participants (12,251 incident cases over 16.6 years), and conducted a targeted genetic analysis in the ColoRectal Transdisciplinary Study, Colon Cancer Family Registry, and Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO). Alcohol (relative risk per 20 g/day=1.15, 95% confidence interval 1.09-1.20) and calcium (per 300 mg/day=0.83, 0.77–0.89) intakes had the strongest associations, followed by six dairy-related factors associated with calcium. We showed a positive association with red and processed meat intake and weaker inverse associations with breakfast cereal, fruit, wholegrains, carbohydrates, fibre, total sugars, folate, and vitamin C. Genetically predicted milk consumption was inversely associated with risk of colorectal, colon, and rectal cancers. We conclude that dairy products help protect against colorectal cancer, and that this is driven largely or wholly by calcium.
Colorectal cancer is the third most common cancer in the world, with an estimated 1,926,425 incident cases in 20221. The incidence rates vary markedly, with higher rates in high income countries including most European countries, North America, Australia, New Zealand and Japan, and lower rates in low income countries including much of Africa and south Asia1, although the rates in lower incidence areas appear to be increasing2. In addition, colorectal cancer rates in migrants have been shown to change within as little as just over a decade towards those of their adopted country3, indicating that lifestyle and environmental factors are involved in the aetiology of this cancer.
