The effect of diet on risk of cancer

doi:10.1016/S0140-6736(02)09958-0

The Lancet

Volume 360, Issue 9336, 14 September 2002, Pages 861-868

https://doi.org/10.1016/S0140-6736(02)09958-0 Get rights and content

Summary

Diet-related factors are thought to account for about 30% of cancers in developed countries. Obesity increases the risk of cancers in the oesophagus, colorectum, breast, endometrium, and kidney. Alcohol causes cancers of the oral cavity, pharynx, larynx, oesophagus, and liver, and causes a small increase in the risk of breast cancer. Adequate intakes of fruit and vegetables probably lower the risk for several types of cancer, especially cancers of the gastrointestinal tract. The importance of other factors, including meat, fibre, and vitamins, is not yet clear. Prudent advice is to eat a varied diet including plenty of fruit, vegetables, and cereals; to maintain a healthy bodyweight with the help of regular physical activity; and to restrict consumption of alcohol.

Section snippets

International comparisons, migrants, and time trends

Many of the prominent hypotheses for the effects of diet on risk of cancer have been derived from investigation of the associations between dietary patterns and cancer rates in various populations. It was noted in the 1970s that people in many western countries had diets high in animal products, fat, and sugar, and high rates of cancers of the colorectum, breast, prostate, endometrium, and lung; by contrast, individuals in developing countries usually had diets that were based on one or two

The role of diet in the cause of common cancers

Panel 1 summarises the established or probable associations of diet and diet-related factors with risk of common cancers. The best-defined effects are those of obesity, which increases risk of cancers of the oesophagus (adenocarcinoma), colorectum, breast, endometrium, and kidney, and of alcohol, which increases the risk of cancers of the oral cavity, pharynx, larynx, oesophagus, liver, and breast. The greatest uncertainties are the effects of some aspects of typical diets in developed

The role of genes in an individual's response to dietary factors

Some common genotypes, such as those involved in metabolic activation, detoxification, DNA methylation, and vitamin metabolism could determine the effects of diet on cancer.⁹⁷ In theory, subdividing participants in a study by genotype could reveal substantial diet-related risks that are obscured when all participants are investigated together. Two examples of promising areas are genetic determinants of carcinogen activation and folate metabolism.98, 99

Recommendations

Despite extensive research during the last 30 years, few specific dietary determinants of cancer risk have been established, even for cancers such as colorectal cancer for which most researchers agree that diet probably has important effects. The main factors that have held back progress are the inaccuracy of methods for estimating food and nutrient intake and the biases in case-control studies. The results of existing large prospective studies and controlled trials should substantially advance

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ReviewThe effect of diet on risk of cancer

Summary

Section snippets

International comparisons, migrants, and time trends

The role of diet in the cause of common cancers

The role of genes in an individual's response to dietary factors

Recommendations

J Nutr

Mutat Res

Food Chem Toxicol

Am J Clin Nutr

Eur J Cancer

Lancet

J Nutr

Lancet Oncol

Breast

J Am Diet Assoc

The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today

J Natl Cancer Inst

Diet in cancer prevention

Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices

Int J Cancer

Globocan

National nutrition survey in Japan

J Epidemiol

National Food Survey

Food, nutrition, and the prevention of cancer: a global perspective

A comparison of prospective and retrospective assessments of diet in the study of breast cancer

Am J Epidemiol

The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers

N Engl J Med

Roles for insulin-like growth factor-1 in mediating the anti-carcinogenic effects of caloric restriction

J Nutr Health Aging

Role of insulin-like growth factor family in cancer development and progression

J Natl Cancer Inst

Cancer: causes, occurrence and control. IARC Scientific Publications No 100

Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population

J Natl Cancer Inst

Nutrition intervention trials in Linxian, China: multiple vitamin/mineral supplementation, cancer incidence, and disease-specific mortality among adults with esophageal dysplasia

J Natl Cancer Inst

Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease

N Engl J Med

Betacarotene supplementation and incidence of cancer and cardiovascular disease: the Women's Health Study

J Natl Cancer Inst

Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease

N Engl J Med

Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial

J Natl Cancer Inst

Decreased incidence of prostate cancer with selenium supplementation: results of a double-blind cancer prevention trial

Br J Urol

Vegetables, fruit and phytoestrogens as preventive agents

Mechanisms by which garlic and allyl sulfur compounds suppress carcinogen bioactivation: garlic and carcinogenesis

Adv Exp Med Biol

Phyto-oestrogens and Western diseases

Ann Med

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J Natl Cancer Inst

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Gastroesophageal reflux, Barrett esophagus, and esophageal cancer: scientific review

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Epidemiology of cancer

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Gut

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Epidemiology of gastric cancer: an evaluation of available evidence

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Review
The effect of diet on risk of cancer