Middle East Journal of Cancer

Association of Dietary Patterns and the Odds of Colorectal Cancer in a Sample of the Population in Southern Iran: An Observational Case-Control Study

Articles in Press

Document Type : Original Article(s)

Authors

Mohsen Mohit 1
Sayedeh Zahra Hosseini 2
Mohammadreza Ravanbod 3
Seyed Vahid Hosseini 4
Najmeh Hejazi 5

1 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

2 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran

4 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

5 Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

10.30476/mejc.2026.110553.2401
Abstract
Background: Colorectal cancer is the second leading cause of cancer-related deaths for both men and women. This study aimed to explore the association between dietary patterns and the odds of colorectal cancer in an Iranian adult population.
Method: This observational case-control study was conducted at three educational and therapeutic centers affiliated with Shiraz University of Medical Sciences. A total of 207 participants were enrolled in the study, comprising 103 individuals with colorectal cancer (case group) and 104 individuals without colorectal cancer (control group). The participants' dietary intake was assessed using a valid and reliable food frequency questionnaire comprising 117 items. Dietary patterns were analyzed using principal component analysis, and their relationship with colorectal cancer was investigated using logistic regression, reporting odds ratios with 95% confidence intervals.
Results: Two main dietary patterns were identified in this study; the high-fiber pattern (HFP) and the unhealthy pattern (UHP). These patterns explained 11.46% and 11.98% of the total variance, respectively. An HFP was significantly associated with  reduced odds of colorectal cancer in both the crude and adjusted models. Conversely, adherence to a UHP was significantly associated with an increased risk of colorectal cancer in both crude and adjusted models.
Conclusion: These findings suggest that adherence to an HFP is associated with a reduced risk of colorectal cancer, whereas adherence to a UHP is associated with an increased risk. Overall, these results underscore the importance of modifying dietary habits as a strategic approach to the prevention of colorectal cancer among the adult population in Iran.

Highlights

Najmeh Hejazi (google scholar)

Keywords

Dietary pattern
Colorectal neoplasms
Dietary fiber
Fast food
Subjects

Please cite this article as: Mohit M, Hosseini SZ, Ravanbod M, Hosseini SV, Hejazi N. Association of Dietary Patterns and the Odds of Colorectal Cancer in a Sample of the Population in Southern Iran: An Observational Case-Control Study. Middle East J Cancer. 2026: in press. doi: 10.30476/mejc.2026.110553.2401.

  1. Siegel RL, Miller KD, Goding Sauer A, Fedewa SA, Butterly LF, Anderson JC, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70(3):145-64. doi: 10.3322/caac.21601. PMID: 32133645.
  2. Mohebbi E, Nahvijou A, Hadji M, Rashidian H, Seyyedsalehi MS, Nemati S, et al. Iran Cancer Statistics in 2012 and projection of cancer incidence by 2035. Basic Clin Cancer Res. 2018;9(3):3-22.
  3. Dulai PS, Sandborn WJ, Gupta S. Colorectal cancer and dysplasia in inflammatory bowel disease: A review of disease epidemiology, pathophysiology, and management. Cancer Prev Res (Phila). 2016;9(12):887-94. doi: 10.1158/1940-6207.CAPR-16-0124. PMID: 27679553; PMCID: PMC5289746.
  4. Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol. 2019;14(2):89-103. doi: 10.5114/pg.2018.81072. PMID: 31616522; PMCID: PMC6791134.
  5. Schwingshackl L, Schwedhelm C, Hoffmann G, Knüppel S, Laure Preterre A, Iqbal K, et al. Food groups and risk of colorectal cancer. Int J Cancer. 2018;142(9):1748-58. doi: 10.1002/ijc.31198. PMID: 29210053.
  6. Warren Andersen S, Blot WJ, Lipworth L, Steinwandel M, Murff HJ, Zheng W. Association of race and socioeconomic status with colorectal cancer screening, colorectal cancer risk, and mortality in southern US adults. JAMA Netw Open. 2019;2(12):e1917995. doi: 10.1001/jamanetworkopen.2019.17995. PMID: 31860105; PMCID: PMC6991213.
  7. Douaiher J, Ravipati A, Grams B, Chowdhury S, Alatise O, Are C. Colorectal cancer-global burden, trends, and geographical variations. J Surg Oncol. 2017;115(5):619-30. doi: 10.1002/jso.24578. PMID: 28194798.
  8. Melkonian SC, Jim MA, Haverkamp D, Wiggins CL, McCollum J, White MC, et al. Disparities in cancer incidence and trends among American Indians and Alaska natives in the United States, 2010-2015. Cancer Epidemiol Biomarkers Prev. 2019;28(10):1604-11. doi: 10.1158/1055-9965.EPI-19-0288. PMID: 31575554; PMCID: PMC6777852.
  9. Abe S, Zhang S, Tomata Y, Tsuduki T, Sugawara Y, Tsuji I. Japanese diet and survival time: The Ohsaki Cohort 1994 study. Clin Nutr. 2020;39(1):298-303. doi: 10.1016/j.clnu.2019.02.010. PMID: 30846323.
  10. Kim SH, Moon JY, Lim YJ. Dietary intervention for preventing colorectal cancer: A practical guide for physicians. J Cancer Prev. 2022;27(3):139-46. doi: 10.15430/JCP.2022.27.3.139. PMID: 36258718; PMCID: PMC9537579.
  11. Tabung FK, Brown LS, Fung TT. Dietary Patterns and Colorectal Cancer Risk: A review of 17 years of evidence (2000-2016). Curr Colorectal Cancer Rep. 2017;13(6):440-54. doi: 10.1007/s11888-017-0390-5. PMID: 29399003; PMCID: PMC5794031.
  12. Tabung FK, Brown LS, Fung TT. Dietary patterns and colorectal cancer risk: A review of 17 years of evidence (2000-2016). Curr Colorectal Cancer Rep. 2017;13(6):440-54. doi: 10.1007/s11888-017-0390-5. PMID: 29399003; PMCID: PMC5794031.
  13. Rostampoor Z, Afrashteh S, Mohammadianpanah M, Ghaem H, Zeegers MP, Fararouei M. Lifestyle, dietary pattern and colorectal cancer: a case-control study. BMC Nutr. 2024;10(1):138. doi: 10.1186/s40795-024-00950-x. PMID: 39420424; PMCID: PMC11488227.
  14. Eghtesad S, Masoudi S, Sharafkhah M, Rashidkhani B, Esmaeili-Nadimi A, Najafi F, et al. Validity and reproducibility of the PERSIAN Cohort food frequency questionnaire: assessment of major dietary patterns. Nutr J. 2024;23(1):35. doi: 10.1186/s12937-024-00938-0. PMID: 38481332; PMCID: PMC10935787.
  15. Orta J. Nutritionist IV for Windows. Journal of the American Dietetic Association. 1994;94:936-8. Available at: https://go.gale.com/ps/i.do?id=GALE%7CA15721485&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=00028223&sw=w&p=HRCA&userGroupName=anon%7Eb7077307&aty=open-web-entry
  16. Chan OY, Tao L, Chen G, Kong L. The association of dietary fiber intake with colorectal cancer and related risks: a literature review of recent research. Journal of Agriculture and Food Research. 2025;21:101999. doi:10.1016/j.jafr.2025.101999.
  17. Song M, Chan AT. Environmental factors, gut microbiota, and colorectal cancer prevention. Clin Gastroenterol Hepatol. 2019;17(2):275-89. doi: 10.1016/j.cgh.2018.07.012. PMID: 30031175; PMCID: PMC6314893.
  18. Xi Y, Jing Z, Wei W, Chun Z, Quan Q, Qing Z, et al. Inhibitory effect of sodium butyrate on colorectal cancer cells and construction of the related molecular network. BMC Cancer. 2021;21(1):127. doi: 10.1186/s12885-021-07845-1. PMID: 33549042; PMCID: PMC7866666.
  19. Hammerling U, Bergman Laurila J, Grafström R, Ilbäck NG. Consumption of Red/Processed Meat and Colorectal Carcinoma: Possible mechanisms underlying the significant association. Crit Rev Food Sci Nutr. 2016;56(4):614-34. doi: 10.1080/10408398.2014.972498. PMID: 25849747.
  20. Kobayashi J. Effect of diet and gut environment on the gastrointestinal formation of N-nitroso compounds: A review. Nitric Oxide. 2018;73:66-73. doi: 10.1016/j.niox.2017.06.001. PMID: 28587887.
  21. Hoxha M, Zappacosta B. A review on the role of fatty acids in colorectal cancer progression. Front Pharmacol. 2022;13:1032806. doi: 10.3389/fphar.2022.1032806. PMID: 36578540; PMCID: PMC9791100.
  22. Cui Y, Liu H, Zhang L, Zhang H, Wang Z, Wang J, et al. Fructose drives colorectal cancer progression by regulating crosstalk between cancer-associated fibroblasts and tumour cells. Gut. 2025:gutjnl-2025-335014. doi: 10.1136/gutjnl-2025-335014. Epub ahead of print. PMID: 40935617.
  23. Mehta RS, Song M, Nishihara R, Drew DA, Wu K, Qian ZR, et al. Dietary patterns and risk of colorectal cancer: Analysis by tumor location and molecular subtypes. Gastroenterology. 2017;152(8):1944-53.e1. doi: 10.1053/j.gastro.2017.02.015. PMID: 28249812; PMCID: PMC5447483.
Middle East Journal of Cancer

Articles in Press, Accepted Manuscript
Available Online from 01 January 2027

Home

Guide for Authors

Submit Manuscript

Guide for Reviewers

Contact Us