Frontiers in nutrition · 2026
Ultra-processed food intake and risk of digestive system cancers: a systematic review and dose-response meta-analysis.
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Jiang Yanjie, Zhang Shipeng, Wang Hanyu, He Xingyi, Jin Zhihui, Fu Rui, Fu Qinwei, Li Wenshan, Zhu Xiaoyu, Li Zhuohong, Sun Xin, Lu Yan
Аннотация
BACKGROUND: Ultra-processed food (UPF) intake has been associated with digestive system cancer risk, but evidence remains scattered across cancer sites, study designs, and exposure metrics. This systematic review and meta-analysis evaluated associations between UPF intake and digestive system cancer risk overall and by cancer site. We further examined UPF subcategories and dose-response relationships.
METHODS: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for English-language cohort and case-control studies published from database inception to May 1, 2026. Hazard ratios (HRs) from cohort studies and odds ratios (ORs) from case-control studies were pooled separately with their corresponding 95% confidence intervals (CIs) using random-effects models. Additional analyses were conducted to investigate site-specific digestive system cancers, UPF subcategories, and dose-response relationships, alongside subgroup, sensitivity, meta-regression, and publication bias assessments. The study protocol was registered in PROSPERO (CRD420261404299).
RESULTS: A total of nine prospective cohort studies and five case-control studies were included. The main pooled estimates showed a 12% higher risk in cohort studies (HR = 1.12, 95% CI: 1.05-1.20; I 2 = 37.6%) and 42% higher odds in case-control studies (OR = 1.42, 95% CI: 1.25-1.60; I 2 = 26.7%). Site-specific analyses showed relatively consistent positive associations for colorectal and colon cancer outcomes. Among UPF subcategories, ultra-processed meat/protein products were associated with higher digestive system cancer risk (HR = 1.33, 95% CI: 1.15-1.53). In dose-response analyses using UPF weight share as the primary exposure metric, each 10-percentage-point increase in UPF intake was associated with a 6% higher risk (HR = 1.06, 95% CI: 1.01-1.10), with evidence of non-linearity, although no reliable threshold could be identified. Supplementary analyses based on g/day showed a consistent direction of association. Sensitivity analyses supported the stability of the main findings, and no clear evidence of publication bias was observed.
CONCLUSION: Higher UPF intake was associated with increased digestive system cancer risk, with relatively consistent evidence for colorectal and colon cancers. Ultra-processed meat/protein products may be a relevant contributing subcategory, and dose-response analyses suggested an exposure-response gradient. Because evidence came mainly from observational studies and dose-response data were limited, findings require confirmation in high-quality prospective studies.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261404299, identifier PROSPERO (CRD420261404299).
METHODS: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for English-language cohort and case-control studies published from database inception to May 1, 2026. Hazard ratios (HRs) from cohort studies and odds ratios (ORs) from case-control studies were pooled separately with their corresponding 95% confidence intervals (CIs) using random-effects models. Additional analyses were conducted to investigate site-specific digestive system cancers, UPF subcategories, and dose-response relationships, alongside subgroup, sensitivity, meta-regression, and publication bias assessments. The study protocol was registered in PROSPERO (CRD420261404299).
RESULTS: A total of nine prospective cohort studies and five case-control studies were included. The main pooled estimates showed a 12% higher risk in cohort studies (HR = 1.12, 95% CI: 1.05-1.20; I 2 = 37.6%) and 42% higher odds in case-control studies (OR = 1.42, 95% CI: 1.25-1.60; I 2 = 26.7%). Site-specific analyses showed relatively consistent positive associations for colorectal and colon cancer outcomes. Among UPF subcategories, ultra-processed meat/protein products were associated with higher digestive system cancer risk (HR = 1.33, 95% CI: 1.15-1.53). In dose-response analyses using UPF weight share as the primary exposure metric, each 10-percentage-point increase in UPF intake was associated with a 6% higher risk (HR = 1.06, 95% CI: 1.01-1.10), with evidence of non-linearity, although no reliable threshold could be identified. Supplementary analyses based on g/day showed a consistent direction of association. Sensitivity analyses supported the stability of the main findings, and no clear evidence of publication bias was observed.
CONCLUSION: Higher UPF intake was associated with increased digestive system cancer risk, with relatively consistent evidence for colorectal and colon cancers. Ultra-processed meat/protein products may be a relevant contributing subcategory, and dose-response analyses suggested an exposure-response gradient. Because evidence came mainly from observational studies and dose-response data were limited, findings require confirmation in high-quality prospective studies.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261404299, identifier PROSPERO (CRD420261404299).