The Link between Food Environment and Colorectal Cancer: A Systematic Review

Abstract

Food and diet are critical risk factors for colorectal cancer (CRC). Food environments (FEs) can contribute to disease risk, including CRC. This review investigated the link between FEs and CRC incidence and mortality risk. The systematic search of studies utilised three primary journal databases: PubMed, Scopus, and Web of Science. Retrieved citations were screened and the data were extracted from articles related to the FE-exposed populations who were at risk for CRC and death. We evaluated ecological studies and cohort studies with quality assessment and the Newcastle-Ottawa Quality Assessment Form for Cohort Studies, respectively. A descriptive synthesis of the included studies was performed. Out of 89 articles identified, eight were eligible for the final review. The included studies comprised six ecological studies and two cohort studies published from 2013 to 2021. Six articles were from the US, one was from Africa, and one was from Switzerland. All eight studies were of good quality. The significant finding was that CRC incidence was associated with the availability of specific foods such as red meat, meat, animal fats, energy from animal sources, and an unhealthy FE. Increased CRC mortality was linked with the availability of animal fat, red meat, alcoholic beverages, and calorie food availability, residence in food deserts, and lower FE index. There were a variety of associations between CRC and the FE. The availability of specific foods, unhealthy FE, and food desserts impact CRC incidence and mortality. Creating a healthy FE in the future will require focus and thorough planning.

Who, where, when: Colorectal cancer disparities by race and ethnicity, subsite, and stage

“…Differences in neighborhood and built environments can also contribute to health disparities. For example, Black and Hispanic populations are more likely to live in neighborhoods that lack access to healthy food options, recreational spaces for physical activity, and healthcare facilities to receive preventive services, all of which may contribute to the poorer CRC outcomes observed 27,28 …”

“…For example, Black and Hispanic populations are more likely to live in neighborhoods that lack access to healthy food options, recreational spaces for physical activity, and healthcare facilities to receive preventive services, all of which may contribute to the poorer CRC outcomes observed. 27,28 While lifestyle and environmental factors impact risk of developing the disease, the observed differences in disease stage and survival by race/ethnicity likely result from inequities in access to and knowledge of CRC T A B L E 5 (Continued) screening and treatment services. Racial/ethnic minority populations have consistently lower CRC screening rates than White counterparts, which, in turn, contribute to later stage diagnosis and subsequent poorer survival in minority patients.…”

Closing the Gap: Approaches to Improving Colorectal Surgery Care for the Uninsured and Underinsured

“…For example, uninsured individuals are more likely to live in low-income neighborhoods and food deserts, which have been linked to higher CRC incidence and mortality. 20 The ability to diagnose and manage comorbid risk factors in this population is further limited by coexisting barriers to health care access such as lack of coverage, limited provider networks, and financial constraints.…”

Emerging Role of Plant-Based Dietary Components in Post-Translational Modifications Associated with Colorectal Cancer

“…Among them, cigarette smoking, obesity, and a sedentary lifestyle are closely related to CRC incidence [ 4 , 5 ]. However, its quickly increasing incidence is mainly due to lifestyle westernization associated with changes in dietary behaviour such as heavy alcohol consumption and diets rich in sugars, saturated fats, and red and processed meat [ 6 ]. Thus, some protective lifestyle factors against CRC include a diet rich in minerals and vitamins, dairy, dietary fibre, fish, vegetables, and fruits.…”