NIMHD-Supported Research Study Estimates Preventable Cancer Burden Linked to Poor Diet in the U.S.

The "Preventable Cancer Burden Associated with Poor Diet in the United States," published in Journal of the National Cancer Institute (JNCI), Cancer Spectrum, estimates that diet-related factors may account for 80,110 of the new invasive cancer cases reported in 2015, or 5.2 percent of that year’s total among U.S. adults. This is comparable to the cancer burden associated with alcohol, which is 4 to 6 percent. Excessive body weight, meanwhile, is associated with 7 to 8 percent of the cancer burden, and physical inactivity is associated with 2 to 3 percent.

“Our findings underscore the opportunity to reduce the cancer burden and disparities in the United States by improving food intake,” said first and corresponding author Dr. Fang Fang Zhang, a cancer and nutrition researcher at the Friedman School of Nutrition Science and Policy at Tufts University, also supported by the National Institutes of Health’s National Institute on Minority Health and Health Disparities (R01MD011501) and National Heart, Lung, and Blood Institute (R01HL115189).

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Abstract

Background

Diet is an important risk factor for cancer that is amenable to intervention. Estimating the cancer burden associated with diet informs evidence-based priorities for nutrition policies to reduce cancer burden in the US.

Methods

Using a Comparative Risk Assessment model that incorporated nationally representative data on dietary intake, national cancer incidence, and estimated associations of diet with cancer risk from meta-analyses of prospective cohort studies, we estimated the annual number and proportion of new cancer cases attributable to suboptimal intakes of 7 dietary factors among US adults ages 20+ years, and by population subgroups.

Results

An estimated 80110 (95% uncertainty interval [UI]: 76316-83657) new cancer cases were attributable to suboptimal diet, accounting for 5.2% (95% UI: 5.0%-5.5%) of all new cancer cases in 2015. Of these, 67488 (95% UI: 63583-70978) and 4.4% (95% UI: 4.2%-4.6%) were attributable to direct associations; and 12589 (95% UI: 12156-13038) and 0.82% (95% UI: 0.79%-0.85%) to obesity-mediated associations. By cancer type, colorectal cancer had the highest number and proportion of diet-related cases (52225, 38.3%). By diet, low consumption of whole grains (27763, 1.8%) and dairy products (17692, 1.2%) and high intake of processed meats (14524, 1.0%) contributed to the highest burden. Men, middle-aged (45-64 years), and racial/ethnic minorities (non-Hispanic blacks, Hispanics, and others) had the highest proportion of diet-associated cancer burden than other age, sex, race/ethnicity groups.

Conclusion

More than 80,000 new cancer cases are estimated to be associated with suboptimal diet among US adults in 2015, with middle-aged men and racial/ethnic minorities experiencing the largest proportion of diet-associated cancer burden in the US.