Fiber Intake and Survival After Colorectal Cancer Diagnosis

Song, Mingyang; Wu, Kana; Meyerhardt, Jeffrey A.; Ogino, Shuji; Wang, Molin; Fuchs, Charles S.; Giovannucci, Edward L.; Chan, Andrew T.

doi:10.1001/jamaoncol.2017.3684

Cited by 198Nutritional Studies and DietFood composition and propertiesColorectal Cancer Screening and Detection

Fiber Intake and Survival After Colorectal Cancer Diagnosis

Open access

Song, Mingyang, Wu, Kana, Meyerhardt, Jeffrey A., Ogino, Shuji, Wang, Molin, Fuchs, Charles S., Giovannucci, Edward L., Chan, Andrew T.·2018·JAMA Oncology

DOI 10.1001/jamaoncol.2017.3684PMC PMC5776713

Open this paper in CoChat — free account Open PDF

Abstract

IMPORTANCE: Although high dietary fiber intake has been associated with a lower risk of colorectal cancer (CRC), it remains unknown whether fiber benefits CRC survivors. OBJECTIVE: To assess the association of postdiagnostic fiber intake with mortality. DESIGN, SETTING, AND PARTICIPANTS: A total of 1575 health care professionals with stage I to III CRC were evaluated in 2 prospective cohorts, Nurses' Health Study and Health Professionals Follow-up Study. Colorectal cancer-specific and overall mortality were determined after adjusting for other potential predictors for cancer survival. The study was conducted from December 23, 2016, to August 23, 2017. EXPOSURES: Consumption of total fiber and different sources of fiber and whole grains assessed by a validated food frequency questionnaire between 6 months and 4 years after CRC diagnosis. MAIN OUTCOMES AND MEASURES: Hazard ratios (HRs) and 95% CIs of CRC-specific and overall mortality after adjusting for other potential predictors for cancer survival. RESULTS: Of the 1575 participants, 963 (61.1%) were women; mean (SD) age was 68.6 (8.9) years. During a median of 8 years of follow-up, 773 deaths were documented, including 174 from CRC. High intake of total fiber after diagnosis was associated with lower mortality. The multivariable HR per each 5-g increment in intake per day was 0.78 (95% CI, 0.65-0.93; P = .006) for CRC-specific mortality and 0.86 (95% CI, 0.79-0.93; P < .001) for all-cause mortality. Patients who increased their fiber intake after diagnosis from levels before diagnosis had a lower mortality, and each 5-g/d increase in intake was associated with 18% lower CRC-specific mortality (95% CI, 7%-28%; P = .002) and 14% lower all-cause mortality (95% CI, 8%-19%; P < .001). According to the source of fiber, cereal fiber was associated with lower CRC-specific mortality (HR per 5-g/d increment, 0.67; 95% CI, 0.50-0.90; P = .007) and all-cause mortality (HR, 0.78; 95% CI, 0.68-0.90; P < .001); vegetable fiber was associated with lower all-cause mortality (HR, 0.83; 95% CI, 0.72-0.96; P = .009) but not CRC-specific mortality (HR, 0.82; 95% CI, 0.60-1.13; P = .22); no association was found for fruit fiber. Whole grain intake was associated with lower CRC-specific mortality (HR per 20-g/d increment, 0.72; 95% CI, 0.59-0.88; P = .002), and this beneficial association was attenuated after adjusting for fiber intake (HR, 0.77; 95% CI, 0.62-0.96; P = .02). CONCLUSIONS AND RELEVANCE: Higher fiber intake after the diagnosis of nonmetastatic CRC is associated with lower CRC-specific and overall mortality. Increasing fiber consumption after diagnosis may confer additional benefits to patients with CRC.

Integrity signals

Registry

Crossref · 10.1001/jamaoncol.2017.3684

Cites

68 of 68 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 23 cited sources checked · 0 supported · 0 flagged

Findingown data
Using cumulative average fiber consumption after diagnosis produced findings similar to the main analysis.
“Similar findings were obtained when cumulative average fiber consumption after diagnosis was used for the analysis (eTable 2).”
Quote in the paperNot a substantial claim
Findingown data
In propensity score analysis, the hazard ratio for all-cause mortality per 5-g/day increment in total fiber was 0.86 (95% CI, 0.79-0.93).
“Similar results were also obtained in the propensity score analysis, with the corresponding HRs of 0.80 (95% CI, 0.67-0.96, P for trend=0.02) and 0.86 (95% CI, 0.79-0.93, P for trend<0.001), respectively, indicating the robustness of our findings to confounding.”
Quote in the paperSubstantial claim
Findingown data
No further reduction in all-cause mortality was found beyond about 24 g/day of fiber intake.
“For all-cause mortality, a statistically significant nonlinear relationship was observed (P=0.007); the benefit associated with increasing fiber intake achieved its maximum at about 24 g/day and no further reduction in mortality was found beyond this level of intake (Figure 1).”
Quote in the paperSubstantial claim
Findingown data
Vegetable fiber intake was associated with lower all-cause mortality (HR per 5-g/day increment, 0.83; 95% CI, 0.72-0.96).
“Vegetable fiber was associated with lower all-cause mortality (HR per 5-g/day increment, 0.83, 95% CI, 0.72-0.96, P for trend=0.009) but not CRC-specific mortality (HR, 0.82, 95% CI, 0.60-1.13, P for trend=0.22).”
Quote in the paperSubstantial claim
Findingown data
No other statistically significant interaction was detected in the subgroup analyses.
“No other statistically significant interaction was detected.”
Quote in the paperNot a substantial claim

Findingown data
The hazard ratio for all-cause mortality per 5-g/day increment in cereal fiber was 0.78 (95% CI, 0.68-0.90).
“The HR associated with 5-g/day increment in cereal fiber was 0.67 (95% CI, 0.50-0.90, P for trend=0.007) for CRC-specific mortality and 0.78 (95% CI, 0.68-0.90, P for trend<0.001) for all-cause mortality.”
Quote in the paperSubstantial claim
Findingown data
In propensity score analysis, the hazard ratio for colorectal cancer-specific mortality per 5-g/day increment in total fiber was 0.80 (95% CI, 0.67-0.96).
“Similar results were also obtained in the propensity score analysis, with the corresponding HRs of 0.80 (95% CI, 0.67-0.96, P for trend=0.02) and 0.86 (95% CI, 0.79-0.93, P for trend<0.001), respectively, indicating the robustness of our findings to confounding.”
Quote in the paperSubstantial claim
Findingown data
The multivariable hazard ratio for all-cause mortality per 5-g/day increment in total fiber intake was 0.86 (95% CI, 0.79-0.93).
“The multivariable HR per each 5-g increase in intake per day was 0.78 (95% CI, 0.65-0.93, P=0.006) for CRC-specific mortality and 0.86 (95% CI, 0.79-0.93, P<0.001) for all-cause mortality.”
Quote in the paperSubstantial claim
Findingown data
Vegetable fiber intake was not associated with colorectal cancer-specific mortality (HR per 5-g/day increment, 0.82; 95% CI, 0.60-1.13).
“Vegetable fiber was associated with lower all-cause mortality (HR per 5-g/day increment, 0.83, 95% CI, 0.72-0.96, P for trend=0.009) but not CRC-specific mortality (HR, 0.82, 95% CI, 0.60-1.13, P for trend=0.22).”
Quote in the paperSubstantial claim
Findingown data
The inverse association of fiber intake with mortality was restricted to low alcohol consumers and non-regular aspirin users.
“We observed a statistically significant interaction with alcohol consumption for CRC-specific mortality (P=0.05) and with regular aspirin use for all-cause mortality (P=0.01): the inverse association of fiber intake with mortality was restricted to low alcohol consumer and non-regular aspirin users.”
Quote in the paperNot a substantial claim
Findingown data
After adjustment for other potential determinants of cancer prognosis, total fiber intake after diagnosis was inversely associated with colorectal cancer-specific mortality.
“As shown in Table 1, fiber intake was inversely associated with CRC-specific mortality after adjusting for other potential determinants for cancer prognosis.”
Quote in the paperSubstantial claim
Findingown data
No statistically significant interaction was detected between fiber intake and tumor subsite or stage.
“No statistically significant interaction was detected between fiber intake and tumor subsite or stage (P for interaction>0.05) (eTable 3).”
Quote in the paperNot a substantial claim
Findingown data
Each 5-g/day increase in fiber intake after diagnosis was associated with 18% lower colorectal cancer-specific mortality (95% CI, 7-28%).
“As shown in Table 1, patients who increased their fiber intake after diagnosis from levels before diagnosis had a lower mortality and each 5-g/day increase in fiber intake was associated with 18% lower CRC-specific mortality (95% CI, 7-28%, P=0.002) and 14% lower all-cause mortality (95% CI, 8-19%, P<0.001).”
Quote in the paperSubstantial claim
Findingown data
In a sensitivity analysis excluding the first year of follow-up, the hazard ratio for colorectal cancer-specific mortality per 5-g/day increment in total fiber was 0.80 (95% CI, 0.66-0.97).
“The results remained essentially unchanged, with the multivariable HR per 5-g/day increment for CRC-specific mortality of 0.80 (95% CI, 0.66-0.97, P for trend=0.02) and the HR for all-cause mortality of 0.85 (95% CI, 0.78-0.93, P for trend=0.002).”
Quote in the paperSubstantial claim
Findingown data
Patients who increased their fiber intake after diagnosis relative to before diagnosis had lower mortality.
“As shown in Table 1, patients who increased their fiber intake after diagnosis from levels before diagnosis had a lower mortality and each 5-g/day increase in fiber intake was associated with 18% lower CRC-specific mortality (95% CI, 7-28%, P=0.002) and 14% lower all-cause mortality (95% CI, 8-19%, P<0.001).”
Quote in the paperSubstantial claim
Findingown data
A statistically significant interaction was observed between fiber intake and alcohol consumption for colorectal cancer-specific mortality (P=0.05).
“We observed a statistically significant interaction with alcohol consumption for CRC-specific mortality (P=0.05) and with regular aspirin use for all-cause mortality (P=0.01): the inverse association of fiber intake with mortality was restricted to low alcohol consumer and non-regular aspirin users.”
Quote in the paperNot a substantial claim
Findingown data
The association between whole grain intake and colorectal cancer-specific mortality was attenuated after adjusting for total fiber intake (HR, 0.77; 95% CI, 0.62-0.96).
“This association was attenuated after adjusting for total fiber intake (HR=0.77, 95% CI, 0.62-0.96, P for trend=0.02).”
Quote in the paperSubstantial claim
Findingown data
Each 5-g/day increase in fiber intake after diagnosis was associated with 14% lower all-cause mortality (95% CI, 8-19%).
“As shown in Table 1, patients who increased their fiber intake after diagnosis from levels before diagnosis had a lower mortality and each 5-g/day increase in fiber intake was associated with 18% lower CRC-specific mortality (95% CI, 7-28%, P=0.002) and 14% lower all-cause mortality (95% CI, 8-19%, P<0.001).”
Quote in the paperSubstantial claim
Findingown data
In the same sensitivity analysis excluding the first year, the hazard ratio for all-cause mortality per 5-g/day increment in total fiber was 0.85 (95% CI, 0.78-0.93).
“The results remained essentially unchanged, with the multivariable HR per 5-g/day increment for CRC-specific mortality of 0.80 (95% CI, 0.66-0.97, P for trend=0.02) and the HR for all-cause mortality of 0.85 (95% CI, 0.78-0.93, P for trend=0.002).”
Quote in the paperSubstantial claim
Findingown data
Patients in the highest quartile of fiber intake were more likely to have stage I cancer than other patients.
“Anatomic subsite and grade of differentiation did not differ across quartiles of fiber intake, whereas patients with the highest fiber intake were more likely to have stage I cancer than others.”
Quote in the paperNot a substantial claim
Findingown data
For all-cause mortality, a statistically significant nonlinear relationship was observed between fiber intake and mortality (P=0.007).
“For all-cause mortality, a statistically significant nonlinear relationship was observed (P=0.007); the benefit associated with increasing fiber intake achieved its maximum at about 24 g/day and no further reduction in mortality was found beyond this level of intake (Figure 1).”
Quote in the paperSubstantial claim
Findingown data
The hazard ratio for colorectal cancer-specific mortality per 5-g/day increment in cereal fiber was 0.67 (95% CI, 0.50-0.90).
“The HR associated with 5-g/day increment in cereal fiber was 0.67 (95% CI, 0.50-0.90, P for trend=0.007) for CRC-specific mortality and 0.78 (95% CI, 0.68-0.90, P for trend<0.001) for all-cause mortality.”
Quote in the paperSubstantial claim
Findingown data
Whole grain consumption was associated with lower colorectal cancer-specific mortality (HR per 20-g/day increment, 0.72; 95% CI, 0.59-0.88).
“Whole grain consumption was associated with lower CRC-specific mortality, with the multivariable HR per 20-g/day increment of 0.72 (95% CI, 0.59-0.88, P for trend=0.002) (Table 3).”
Quote in the paperSubstantial claim
Findingown data
The multivariable hazard ratio for colorectal cancer-specific mortality per 5-g/day increment in total fiber intake was 0.78 (95% CI, 0.65-0.93).
“The multivariable HR per each 5-g increase in intake per day was 0.78 (95% CI, 0.65-0.93, P=0.006) for CRC-specific mortality and 0.86 (95% CI, 0.79-0.93, P<0.001) for all-cause mortality.”
Quote in the paperSubstantial claim
Findingown data
Whole grain intake was associated with lower all-cause mortality (HR per 20-g/day increment, 0.88; 95% CI, 0.80-0.97).
“Similar, but weaker, attenuation was observed for all-cause mortality, with the HR changing from 0.88 (95% CI, 0.80-0.97, P for trend=0.008) to 0.91 (0.83-1.01, P for trend=0.08) after including fiber in the multivariable model.”
Quote in the paperSubstantial claim
Findingown data
After including fiber in the multivariable model, the whole grain all-cause mortality hazard ratio attenuated to 0.91 (95% CI, 0.83-1.01).
“Similar, but weaker, attenuation was observed for all-cause mortality, with the HR changing from 0.88 (95% CI, 0.80-0.97, P for trend=0.008) to 0.91 (0.83-1.01, P for trend=0.08) after including fiber in the multivariable model.”
Quote in the paperSubstantial claim
Findingown data
A statistically significant interaction was observed between fiber intake and regular aspirin use for all-cause mortality (P=0.01).
“We observed a statistically significant interaction with alcohol consumption for CRC-specific mortality (P=0.05) and with regular aspirin use for all-cause mortality (P=0.01): the inverse association of fiber intake with mortality was restricted to low alcohol consumer and non-regular aspirin users.”
Quote in the paperNot a substantial claim
Findingown data
After mutual adjustment for fruit and vegetable fiber, cereal fiber showed an inverse association with lower mortality.
“As shown in Table 2, fiber from cereals showed an inverse association with lower mortality after mutual adjustment for fruit and vegetable fiber.”
Quote in the paperSubstantial claim
Findingown data
Spline analysis showed a linear relationship between total fiber intake after diagnosis and colorectal cancer-specific mortality.
“The spline analysis showed a linear relationship between fiber intake after diagnosis and CRC-specific mortality.”
Quote in the paperNot a substantial claim
Findingown data
Fiber intakes from cereals, vegetables, and fruits were weakly correlated (Spearman r<0.25).
“Fiber intakes from these sources were weakly correlated (Spearman correlation coefficient r<0.25, eTable 4).”
Quote in the paperNot a substantial claim
Interpretationown data
The similarity of results from multivariable adjustment and propensity score analysis indicates that the findings are robust to confounding.
“Similar results were also obtained in the propensity score analysis, with the corresponding HRs of 0.80 (95% CI, 0.67-0.96, P for trend=0.02) and 0.86 (95% CI, 0.79-0.93, P for trend<0.001), respectively, indicating the robustness of our findings to confounding.”
Quote in the paperSubstantial claim
Study design and conductown data
Data on cancer recurrences were unavailable in the cohorts.
“Second, beyond cause of mortality, data on cancer recurrences were unavailable in our cohorts.”
Quote in the paperSubstantial claim
Premisecitation
Hyperinsulinemia and markers of insulin resistance and inflammation may mediate the adverse metabolic effect of obesity and physical inactivity on colorectal cancer recurrence and death.
“Emerging, albeit limited, evidence suggests that hyperinsulinemia and markers of insulin resistance and inflammation predict worse survival in CRC patients,38,39 and may mediate the adverse metabolic effect of obesity and physical inactivity on CRC recurrence and death.23,40”
Quote in the paperSubstantial claim0 of 2 sources checked
- cites [23] Meyerhardt JA Giovannucci EL Ogino S Physical activity and male colorectal cancer survival Arch Intern Med 2009 169 22 2102 2108 20008694 PMC2852183
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [40] Cespedes Feliciano EM Kroenke CH Meyerhardt JA Metabolic Dysfunction, Obesity, and Survival Among Patients With Early-Stage Colorectal Cancer J Clin Oncol 2016 PMC5065112 27601537
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Premisecitation
A meta-analysis of 25 prospective studies found that each 10-g increment in daily total or cereal fiber intake was associated with about 10% lower risk of developing colorectal cancer.
“According to a recent meta-analysis of 25 prospective studies, each 10-gram increment in daily intake of total and cereal fiber was associated with approximately 10% lowered risk of developing CRC.31”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [31] Aune D Chan DS Lau R Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies BMJ 2011 343 d6617 22074852 PMC3213242
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Interpretationcitation
Because median survival for metastatic colorectal cancer was about 10 to 12 months during much of the study period, colorectal cancer-specific mortality should be a reasonable surrogate for cancer-specific outcomes.
“Nevertheless, because the median survival for metastatic CRC was approximately 10 to 12 months during much of the period of this study,59 CRC-specific mortality should be a reasonable surrogate for cancer-specific outcomes.”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [59] Meyerhardt JA Mayer RJ Systemic therapy for colorectal cancer N Engl J Med 2005 352 5 476 487 15689586
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Study design and conductnone given
The number of colorectal cancer-specific deaths in the study was relatively small.
“Third, the number of CRC-specific deaths is relatively small, and therefore further large-scale studies are needed.”
Quote in the paperSubstantial claim
Study design and conductreasoning
Detailed covariate data collected in parallel with fiber intake allowed rigorous control for confounding by various predictors of cancer survival.
“Moreover, the detailed covariate data collected in parallel with fiber intake allowed for rigorous control for confounding by various predictors of cancer survival.”
Quote in the paperSubstantial claim
Premisecitation
Substantial evidence supports a protective effect of high fiber intake against colorectal cancer development.
“Substantial evidence supports the protective effect of high fiber intake for CRC prevention.”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [31] Aune D Chan DS Lau R Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies BMJ 2011 343 d6617 22074852 PMC3213242
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Study design and conductnone given
Detailed treatment data were largely unavailable in the cohorts.
“First, detailed treatment data were largely unavailable in the cohorts.”
Quote in the paperSubstantial claim
Interpretationown data
The findings provide novel evidence for a potential benefit of increasing fiber and whole grain consumption among colorectal cancer patients.
“Our findings provide novel evidence for the potential benefit of increasing fiber and whole grain consumption among CRC patients.”
Quote in the paperSubstantial claim
Interpretationreasoning
Higher fiber intake after colorectal cancer diagnosis may improve survival by mitigating the tumor-promoting effect of hyperinsulinemia and inflammation.
“Therefore, higher fiber intake after CRC diagnosis may improve patients’ survival by mitigating the tumor-promoting effect of hyperinsulinemia and inflammation.”
Quote in the paperSubstantial claim
Premisecitation
Bacterial fermentation of fiber produces butyrate.
“Bacterial fermentation of fiber also produces butyrate, which has been increasingly implicated in modulation of the tumor microenvironment.41”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [41] Encarnacao JC Abrantes AM Pires AS Botelho MF Revisit dietary fiber on colorectal cancer: butyrate and its role on prevention and treatment Cancer Metastasis Rev 2015 34 3 465 478 26224132
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Study design and conductown data
The study collected detailed pre-diagnostic and post-diagnostic diet and lifestyle information.
“Advantages of the current study include the prospective design, detailed collection of pre- and post-diagnostic diet and lifestyle information, standardized medical record review of self-reported CRC and deaths, and long-term follow-up.”
Quote in the paperSubstantial claim
Study design and conductreasoning
The ability to control for disease stage minimized potential confounding by treatment.
“Thus, our ability to control for stage in our analyses minimized any potential confounding by treatment.”
Quote in the paperSubstantial claim
- Rests on an assumption: During the study period, adjuvant treatment was largely standardized and primarily correlated with disease stage.
Premisecitation
Butyrate may influence colorectal cancer prognosis by modulating tumor-infiltrating immune cells, including regulatory T cells and macrophages.
“Moreover, butyrate may influence CRC prognosis by modulating the function of tumor-infiltrating immune cells, including regulatory T cells42,43 and macrophages,44 which have been increasingly recognized for their critical roles in tumor-host interactions and cancer prognosis.45,46”
Quote in the paperNot a substantial claim0 of 3 sources checked
- cites [42] Smith PM Howitt MR Panikov N The microbial metabolites, short-chain fatty acids, regulate colonic Treg cell homeostasis Science 2013 341 6145 569 573 23828891 PMC3807819
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [43] Arpaia N Campbell C Fan X Metabolites produced by commensal bacteria promote peripheral regulatory T-cell generation Nature 2013 504 7480 451 455 24226773 PMC3869884
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [44] Chang PV Hao L Offermanns S Medzhitov R The microbial metabolite butyrate regulates intestinal macrophage function via histone deacetylase inhibition Proc Natl Acad Sci U S A 2014 111 6 2247 2252 24390544 PMC3926023
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Premisecitation
Emerging evidence suggests that hyperinsulinemia and markers of insulin resistance and inflammation predict worse survival in colorectal cancer patients.
“Emerging, albeit limited, evidence suggests that hyperinsulinemia and markers of insulin resistance and inflammation predict worse survival in CRC patients,38,39 and may mediate the adverse metabolic effect of obesity and physical inactivity on CRC recurrence and death.23,40”
Quote in the paperSubstantial claim0 of 2 sources checked
- cites [38] Volkova E Willis JA Wells JE Robinson BA Dachs GU Currie MJ Association of angiopoietin-2, C-reactive protein and markers of obesity and insulin resistance with survival outcome in colorectal cancer Br J Cancer 2011 104 1 51 59 21081932 PMC3039823
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [39] Wolpin BM Meyerhardt JA Chan AT Insulin, the insulin-like growth factor axis, and mortality in patients with nonmetastatic colorectal cancer J Clin Oncol 2009 27 2 176 185 19064975 PMC2645084
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Study design and conductreasoning
Because all participants were health professionals, differences in access to adjuvant chemotherapy are minimized.
“In addition, because all participants were health professionals, any difference in access to adjuvant chemotherapy is minimized.”
Quote in the paperNot a substantial claim
Study design and conductown data
The study had long-term follow-up.
“Advantages of the current study include the prospective design, detailed collection of pre- and post-diagnostic diet and lifestyle information, standardized medical record review of self-reported CRC and deaths, and long-term follow-up.”
Quote in the paperSubstantial claim
Study design and conductown data
The study had a prospective design.
“Advantages of the current study include the prospective design, detailed collection of pre- and post-diagnostic diet and lifestyle information, standardized medical record review of self-reported CRC and deaths, and long-term follow-up.”
Quote in the paperSubstantial claim

May combine two claims. 10
Classified as probably not a substantial claim. 8
The quote only partly states this claim. 2

May combine two claims.
Findingown data
The observed 5-year survival rates were 83% for stage I, 82% for stage II, and 72% for stage III colorectal cancer.
“The overall 5-year survival rates were 83% (95% CI, 79-86%) for stage I cancer, 82% (95% CI, 78-86%) for stage II cancer, and 72% (95% CI, 67-76%) for stage III cancer.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data
Pre-diagnostic and post-diagnostic fiber intakes were modestly correlated (Spearman r=0.58).
“Pre- and post-diagnostic intake of fiber was modestly correlated (Spearman correlation coefficient r=0.58).”
Quote in the paperNot a substantial claim
May combine two claims.
Findingown data
In the combined NHS and HPFS cohorts, 1,575 patients with stage I to III colorectal cancer were followed for a median of 8 years, during which 773 deaths occurred, 174 of them from colorectal cancer.
“Among 1,575 eligible patients diagnosed with stage I to III CRC, we documented 773 deaths, of which 174 were classified as CRC-specific deaths over a median of 8 years of follow-up.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data
Among the subset of patients with chemotherapy data, fiber intake was similar between those who received chemotherapy and those who did not.
“In a subset of patients with chemotherapy data (n=375), fiber intake was similar among those who received chemotherapy (median=19.5 g/day) versus those who did not (median=19.1 g/day) (P for Wilcoxon test =0.13).”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown data
Patients with higher fiber intake tended to have a healthier lifestyle.
“Participants with higher fiber intake tended to have a healthier lifestyle (eTable 1).”
Quote in the paperNot a substantial claim
May combine two claims.
Findingown data
Anatomic subsite and grade of differentiation did not differ across quartiles of fiber intake.
“Anatomic subsite and grade of differentiation did not differ across quartiles of fiber intake, whereas patients with the highest fiber intake were more likely to have stage I cancer than others.”
Quote in the paperNot a substantial claim
The quote only partly states this claim.
Findingown data
The benefit of increasing fiber intake for all-cause mortality reached its maximum at about 24 g/day.
“For all-cause mortality, a statistically significant nonlinear relationship was observed (P=0.007); the benefit associated with increasing fiber intake achieved its maximum at about 24 g/day and no further reduction in mortality was found beyond this level of intake (Figure 1).”
Quote in the paperSubstantial claim
The quote only partly states this claim.
Findingown data
No association was found between fruit fiber intake and mortality.
“In contrast, no association was found for fruit fiber.”
Quote in the paperSubstantial claim
Classified as probably not a substantial claim.
Study design and conductnone given
The study used standardized medical record review of self-reported colorectal cancer and deaths.
“Advantages of the current study include the prospective design, detailed collection of pre- and post-diagnostic diet and lifestyle information, standardized medical record review of self-reported CRC and deaths, and long-term follow-up.”
Quote in the paperSubstantial claim
May combine two claims.
Premisecitation
Animal studies have shown that high-fiber diets promote apoptosis and suppress colorectal tumor development.
“This agrees with the well-established data from animal studies that high-fiber diets promote apoptosis and suppress colorectal tumor development.32–34”
Quote in the paperNot a substantial claim0 of 3 sources checked
- cites [32] Avivi-Green C Polak-Charcon S Madar Z Schwartz B Dietary regulation and localization of apoptosis cascade proteins in the colonic crypt J Cell Biochem 2000 77 1 18 29 10679813
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [33] Fleiszer D Murray D MacFarlane J Brown RA Protective effect of dietary fibre against chemically induced bowel tumours in rats Lancet 1978 2 8089 552 553 79919
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [34] Cao Y Gao X Zhang W Dietary fiber enhances TGF-beta signaling and growth inhibition in the gut Am J Physiol Gastrointest Liver Physiol 2011 301 1 G156 164 21454444 PMC3129933
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Interpretationown data
Higher whole grain consumption was associated with better survival, and this association was partly mediated by fiber.
“Higher consumption of whole grains was also associated with better survival, and this beneficial association was partly mediated by fiber.”
Quote in the paperSubstantial claim
May combine two claims.
Premisecitation
Butyrate is a major energy source for normal colonocytes, is metabolized less in cancer cells due to the Warburg effect, accumulates in the nucleus of cancerous colonocytes, and inhibits histone deacetylase to regulate genes involved in tumor growth, angiogenesis, migration, and chemoresistance.
“Although butyrate is a major energy source for normal colonocytes, it is metabolized to a lesser extent in cancer cells due to the Warburg effect and accumulates in the nucleus of cancerous colonocytes, in which it functions as an inhibitor of histone deacetylase to epigenetically regulate expression of numerous genes responsible for tumor growth, angiogenesis, migration, and chemoresistance.41”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [41] Encarnacao JC Abrantes AM Pires AS Botelho MF Revisit dietary fiber on colorectal cancer: butyrate and its role on prevention and treatment Cancer Metastasis Rev 2015 34 3 465 478 26224132
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Interpretationown data
Higher intake of fiber and whole grains after colorectal cancer diagnosis is associated with lower death rates from colorectal cancer and other causes.
“In conclusion, higher intake of fiber and whole grains after CRC diagnosis is associated with lower rate of death from that disease and other causes.”
Quote in the paperSubstantial claim
May combine two claims.
Interpretationown data
Adjusting for fiber intake attenuated the association between whole grain intake and lower mortality, suggesting that fiber may be an important contributor to the protective effect of whole grains.
“However, in the current study, adjusting for fiber intake indeed attenuated the association between whole grain and lower mortality, suggesting that fiber may be an important contributor for the protective effect of whole grains.58”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites [58] Larsson SC Giovannucci E Bergkvist L Wolk A Whole grain consumption and risk of colorectal cancer: a population-based cohort of 60,000 women Br J Cancer 2005 92 9 1803 1807 15827552 PMC2362029
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Interpretationown data
The effect of high fiber intake may extend beyond protection against cancer incidence and contribute to better prognosis after cancer is established.
“Our current study adds to the existing literature and suggests that the effect of high fiber intake may extend beyond protection against cancer incidence and contribute to better prognosis after cancer is established.”
Quote in the paperSubstantial claim
Classified as probably not a substantial claim.
Interpretationown data
The findings support nutritional recommendations to maintain sufficient fiber intake among colorectal cancer survivors.
“Our findings provide support for the nutritional recommendations of maintaining sufficient fiber intake among CRC survivors.”
Quote in the paperSubstantial claim
May combine two claims.
Premisecitation
Higher intake of fiber, especially cereal fiber, has been linked to improved insulin sensitivity, lipid profile, endothelial function, and reduced inflammation.
“Higher intake of fiber, especially cereal fiber, has been linked to improved insulin sensitivity,35 lipid profile,36 endothelial function, and reduced inflammation.37”
Quote in the paperSubstantial claim0 of 3 sources checked
- cites [35] Weickert MO Mohlig M Schofl C Cereal fiber improves whole-body insulin sensitivity in overweight and obese women Diabetes Care 2006 29 4 775 780 16567814
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [36] Davy BM Davy KP Ho RC Beske SD Davrath LR Melby CL High-fiber oat cereal compared with wheat cereal consumption favorably alters LDL-cholesterol subclass and particle numbers in middle-aged and older men Am J Clin Nutr 2002 76 2 351 358 12145006
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [37] Qi L van Dam RM Liu S Franz M Mantzoros C Hu FB Whole-grain, bran, and cereal fiber intakes and markers of systemic inflammation in diabetic women Diabetes Care 2006 29 2 207 211 16443861
  Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Interpretationcitation
The observed stage-specific 5-year survival rates in this cohort appeared comparable to national estimates.
“These rates appeared to be comparable to national estimates.30”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites [30] SEER Cancer Statistics Review, 1975–2013 National Cancer Institute 2016 https://seer.cancer.gov/csr/1975_2013/. Accessed August 02, 2017
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoning
As an observational study, residual confounding cannot be excluded.
“Finally, as an observational study, residual confounding cannot be excluded, although we observed similar results through multivariable adjustment and propensity score analysis.”
Quote in the paperNot a substantial claim
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation
Previous observational data on favorable influences of other lifestyle factors on colorectal cancer survival have subsequently been confirmed in randomized trials.
“Of note, previous observational data regarding the favorable influence of other lifestyle factors on CRC survival have been subsequently confirmed in randomized trials.”
Quote in the paperNot a substantial claim0 of 3 sources checked
- cites [60] Schmid D Leitzmann MF Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis Ann Oncol 2014 25 7 1293 1311 24644304
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [61] Maalmi H Ordonez-Mena JM Schottker B Brenner H Serum 25-hydroxyvitamin D levels and survival in colorectal and breast cancer patients: systematic review and meta-analysis of prospective cohort studies Eur J Cancer 2014 50 8 1510 1521 24582912
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [62] Song M Zhang X Meyerhardt JA Marine omega-3 polyunsaturated fatty acid intake and survival after colorectal cancer diagnosis Gut 2016 PMC5247396 27436272
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

20 of 20

The authors state this as an assumption.
Before this study, no prior study had examined the association between fiber intake and survival among colorectal cancer patients.
“Despite these data, to our knowledge no study has yet examined the association between fiber intake and survival of CRC patients.”
The authors state this as an assumption.
This study is the first prospective study to examine the prognostic influence of fiber intake among colorectal cancer patients.
“To our knowledge, this is the first prospective study examining the prognostic influence of fiber intake among CRC patients.”
The paper relies on this without support.
During the study period, adjuvant treatment was largely standardized and primarily correlated with disease stage.
“Moreover, during the time period of the study, adjuvant treatment was largely standardized and primarily correlated with disease stage.”

3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

In colorectal cancer patients, greater consumption of fiber, marine omega-3s, vitamin D, calcium, coffee, or a plant-based low-carbohydrate diet has been linked to longer survival.
“Higher intake of nutrients such as fiber,199 marine omega-3 fatty acid,200–202 vitamin D,203–205 or calcium,203 or coffee206, 207 or a plant-based low-carbohydrate diet207 has been associated with increased survival times of patients with CRC.”
From Influence of the Gut Microbiome, Diet, and Environment on Risk of Colorectal Cancer (2020) · cites this paper as [199]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

Conflicting P values for vegetable fiber and CRC-specific mortality
Minor
The abstract reports P=0.12, while the Results reports P=0.22 for the same vegetable-fiber association. Both give an HR of 0.82 and a 95% CI of 0.60-1.13.

1 of 1

The central role of the propensity score in observational studies for causal effects
ROSENBAUM, P. R., & RUBIN, D. B. (1983) · Biometrika · doi:10.1093/biomet/70.1.41 · Cited by 31,241 · see citing works
Cancer statistics, 2016
Siegel, R. L., Miller, K. D., & Jemal, A. (2016) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21332 · Cited by 16,003 · see citing works
Cancer treatment and survivorship statistics, 2016
Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H., Stein, K. D., Alteri, R., & Jemal, A. (2016) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21349 · Cited by 6,066 · see citing works
The Microbial Metabolites, Short-Chain Fatty Acids, Regulate Colonic T <sub>reg</sub> Cell Homeostasis
Smith, P. M., Howitt, M. R., Panikov, N., Michaud, M., Gallini, C. A., Bohlooly-Y, M., Glickman, J. N., & Garrett, W. S. (2013) · Science · doi:10.1126/science.1241165 · Cited by 5,413 · see citing works
The immune contexture in human tumours: impact on clinical outcome
Fridman, W. H., Pagès, F., Sautès-Fridman, C., & Galon, J. (2012) · Nature reviews. Cancer · doi:10.1038/nrc3245 · Cited by 4,981 · see citing works
Metabolites produced by commensal bacteria promote peripheral regulatory T-cell generation
Arpaia, N., Campbell, C., Fan, X., Dikiy, S., van der Veeken, J., deRoos, P., Liu, H., Cross, J. R., Pfeffer, K., Coffer, P. J., et al. (2013) · Nature · doi:10.1038/nature12726 · Cited by 4,838 · see citing works
Adjustment for total energy intake in epidemiologic studies
Willett, W. C., Howe, G., & Kushi, L. H. (1997) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/65.4.1220s · Cited by 3,747 · see citing works
Flexible regression models with cubic splines
Durrleman, S., & Simon, R. M. (1989) · Statistics in Medicine · doi:10.1002/sim.4780080504 · Cited by 2,701 · see citing works
Health benefits of dietary fiber
Anderson, J. W., Baird, P., Davis Jr, R. H., Ferreri, S., Knudtson, M., Koraym, A., Waters, V., & Williams, C. L. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.2009.00189.x · Cited by 2,239 · see citing works
The microbial metabolite butyrate regulates intestinal macrophage function via histone deacetylase inhibition.
Chang, P. V., Hao, L., Offermanns, S., & Medzhitov, R. (2014) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1322269111 · Cited by 2,175 · see citing works
Nutrition and physical activity guidelines for cancer survivors
Rock, C. L., Doyle, C., Demark‐Wahnefried, W., Meyerhardt, J., Courneya, K. S., Schwartz, A. L., Bandera, E. V., Hamilton, K. K., Grant, B., McCullough, M., et al. (2012) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21142 · Cited by 1,995 · see citing works
Self-citation
Nutritional Epidemiology
Willett, W. C. (2012) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199754038.001.0001 · Cited by 1,754 · see citing works
Review of inverse probability weighting for dealing with missing data
Seaman, S. R., & White, I. R. (2011) · Statistical Methods in Medical Research · doi:10.1177/0962280210395740 · Cited by 1,696 · see citing works
Cancer
Palandri, F., Breccia, M., Bonifacio, M., Polverelli, N., Elli, E. M., Benevolo, G., Tiribelli, M., Abruzzese, E., Iurlo, A., Heidel, F. H., et al. (2006) · Cancer · doi:10.1002/(issn)1097-0142 · Cited by 1,477 · see citing works
Untitled work
Higgins (2002) · doi:10.1002/(issn)1097-0258 · Cited by 1,248 · see citing works
Prospective study of alcohol consumption and risk of coronary disease in men.
Rimm, E. B., Giovannucci, E. L., Willett, W. C., Colditz, G. A., Ascherio, A., Rosner, B., & Stampfer, M. J. (1991) · The Lancet · doi:10.1016/0140-6736(91)90542-w · Cited by 1,239 · see citing works
Self-citation
The glycemic index: methodology and clinical implications
Wolever, T., Jenkins, D., Jenkins, A., & Josse, R. (1991) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/54.5.846 · Cited by 1,168 · see citing works
Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies
Aune, D., Chan, D. S. M., Lau, R., Vieira, R., Greenwood, D. C., Kampman, E., & Norat, T. (2011) · BMJ · doi:10.1136/bmj.d6617 · Cited by 1,146 · see citing works
Systemic Therapy for Colorectal Cancer
Meyerhardt, J. A., & Mayer, R. J. (2005) · New England Journal of Medicine · doi:10.1056/nejmra040958 · Cited by 1,063 · see citing works
Self-citation
Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies
Aune, D., Keum, N., Giovannucci, E., Fadnes, L. T., Boffetta, P., Greenwood, D. C., Tonstad, S., Vatten, L. J., Riboli, E., & Norat, T. (2016) · BMJ · doi:10.1136/bmj.i2716 · Cited by 1,013 · see citing works
Self-citation
Prognostic value of tumor-infiltrating FoxP3+ regulatory T cells in cancers: a systematic review and meta-analysis
Shang, B., Liu, Y., Jiang, S.-J., & Liu, Y. (2015) · Scientific Reports · doi:10.1038/srep15179 · Cited by 985 · see citing works
Systemic Therapy for Colorectal Cancer
Varghese, A. M. (2019) · DeckerMed CGSO Case-Based Reviews · doi:10.2310/cgso.16189 · Cited by 883 · see citing works
Prehabilitation versus Rehabilitation: A Randomized Control Trial in Patients Undergoing Colorectal Resection for Cancer
Gillis, C., Li, C., Lee, L., Awasthi, R., Augustin, B., Gamsa, A., Liberman, A. S., Stein, B., Charlebois, P., Feldman, L. S., et al. (2014) · Anesthesiology · doi:10.1097/aln.0000000000000393 · Cited by 876 · see citing works
TEST OF THE NATIONAL DEATH INDEX
Stampfer, M. J., Willett, W. C., Speizer, F. E., DYSERT, D. C., LIPNICK, R. J., ROSNER, B. A., & Hennekens, C. H. (1984) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a113804 · Cited by 791 · see citing works
Dietary fibre intake and risk of cardiovascular disease: Systematic review and meta-analysis
Threapleton, D. E., Greenwood, D. C., Evans, C. E. L., Cleghorn, C. L., Nykjaer, C., Woodhead, C., Cade, J. E., Gale, C. P., & Burley, V. J. (2013) · BMJ · doi:10.1136/bmj.f6879 · Cited by 749 · see citing works
The Nurses' Health Study: 20-Year Contribution to the Understanding of Health Among Women
Colditz, G. A., Manson, J. E., & Hankinson, S. E. (1997) · Journal of Women s Health · doi:10.1089/jwh.1997.6.49 · Cited by 739 · see citing works
Nutrients, foods, and colorectal cancer prevention
Song, M., Garrett, W. S., & Chan, A. T. (2015) · Gastroenterology · doi:10.1053/j.gastro.2014.12.035 · Cited by 700 · see citing works
Self-citation
Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis
Schmid, D., & Leitzmann, M. F. (2014) · Annals of Oncology · doi:10.1093/annonc/mdu012 · Cited by 630 · see citing works
Effects of Home-Based Diet and Exercise on Functional Outcomes Among Older, Overweight Long-term Cancer Survivors
Morey, M. C., Snyder, D. C., Sloane, R. J., Cohen, H. J., Peterson, B. L., Hartman, T. J., Miller, P. E., Mitchell, D. C., & Demark‐Wahnefried, W. (2009) · JAMA · doi:10.1001/jama.2009.643 · Cited by 523 · see citing works
Reproducibility and Validity of a Self-Administered Physical Activity Questionnaire for Male Health Professionals
Chasan-Taber, S., Rimm, E. B., Stampfer, M. J., Spiegelman, D., Colditz, G. A., Giovannucci, E., Ascherio, A., & Willett, W. C. (1996) · Epidemiology · doi:10.1097/00001648-199601000-00014 · Cited by 508 · see citing works
Self-citation
The Nurses' Health Study
Belanger, C. F., Hennekens, C. H., ROSNER, B. A., & Speizer, F. E. (1978) · AJN American Journal of Nursing · doi:10.2307/3462013 · Cited by 463 · see citing works
Journal of Cellular Biochemistry
Fields, E., Goodman, R., Chizmadzhev, Y., & Shirley-henderson, A. (2006) · Journal of Cellular Biochemistry · doi:10.1002/(issn)1097-4644 · Cited by 335 · see citing works
American Cancer Society Colorectal Cancer Survivorship Care Guidelines
El‐Shami, K., Oeffinger, K. C., Erb, N. L., Willis, A., Bretsch, J. K., Pratt‐Chapman, M. L., Cannady, R. S., Wong, S. L., Rose, J., Barbour, A. L., et al. (2015) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21286 · Cited by 327 · see citing works
Dietary fiber and whole-grain consumption in relation to colorectal cancer in the NIH-AARP Diet and Health Study.
Schatzkin, A., Mouw, T., Park, Y., Subar, A. F., Kipnis, V., Hollenbeck, A., Leitzmann, M. F., & Thompson, F. E. (2007) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.5.1353 · Cited by 317 · see citing works
Cereal fiber improves whole-body insulin sensitivity in overweight and obese women
Weickert, M. O., Möhlig, M., Schöfl, C., Arafat, A. M., Otto, B., Viehoff, H., Koebnick, C., Kohl, A., Spranger, J., & Pfeiffer, A. F. H. (2006) · Diabetes Care · doi:10.2337/diacare.29.04.06.dc05-2374 · Cited by 302 · see citing works
Dietary fiber intake and risk of type 2 diabetes: a dose–response analysis of prospective studies
Yao, B., Fang, H., Xu, W., Yan, Y., Xu, H., Liu, Y., Mo, M., Zhang, H., & Zhao, Y. (2014) · European Journal of Epidemiology · doi:10.1007/s10654-013-9876-x · Cited by 281 · see citing works
Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC).
Murphy, N., Norat, T., Ferrari, P., Jenab, M., Bueno-de-Mesquita, B., Skeie, G., Dahm, C. C., Overvad, K., Olsen, A., Tjønneland, A., et al. (2012) · PLoS ONE · doi:10.1371/journal.pone.0039361 · Cited by 271 · see citing works
Whole-Grain, Bran, and Cereal Fiber Intakes and Markers of Systemic Inflammation in Diabetic Women
Qi, L., van Dam, R. M., Liu, S., Franz, M., Mantzoros, C., & Hu, F. B. (2006) · Diabetes Care · doi:10.2337/diacare.29.02.06.dc05-1903 · Cited by 261 · see citing works
Physical Activity and Male Colorectal Cancer Survival
Meyerhardt, J. A. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.412 · Cited by 260 · see citing works
Self-citation
Mechanisms for the Impact of Whole Grain Foods on Cancer Risk
Slavin, J. L. (2000) · Journal of the American College of Nutrition · doi:10.1080/07315724.2000.10718964 · Cited by 242 · see citing works
Insulin, the insulin-like growth factor axis, and mortality in patients with nonmetastatic colorectal cancer.
Wolpin, B. M., Meyerhardt, J. A., Chan, A. T., Ng, K., Chan, J. A., Wu, K., Pollak, M. N., Giovannucci, E. L., & Fuchs, C. S. (2009) · Journal of Clinical Oncology · doi:10.1200/jco.2008.17.9945 · Cited by 231 · see citing works
Self-citation
Colon carcinogens: Their metabolism and mode of action
Weisburger, J. H. (1971) · Cancer · doi:10.1002/1097-0142(197107)28:1 · Cited by 227 · see citing works
Bias Due to Left Truncation and Left Censoring in Longitudinal Studies of Developmental and Disease Processes
Cain, K. C., Harlow, S. D., Little, R. J. A., Nan, B., Yosef, M., Taffe, J. R., & Elliott, M. R. (2011) · American Journal of Epidemiology · doi:10.1093/aje/kwq481 · Cited by 208 · see citing works
Whole grain consumption and risk of colorectal cancer: a population-based cohort of 60 000 women
Larsson, S. C., Giovannucci, E. L., Bergkvist, L., & Wolk, A. (2005) · British Journal of Cancer · doi:10.1038/sj.bjc.6602543 · Cited by 207 · see citing works
Self-citation
Association Between Dietary Whole Grain Intake and Risk of Mortality: Two Large Prospective Studies in US Men and Women
Wu, H., Flint, A. J., Qi, Q., van Dam, R. M., Sampson, L. A., Rimm, E. B., Holmes, M. D., Willett, W. C., Hu, F. B., & Sun, Q. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2014.6283 · Cited by 191 · see citing works
Diet, exercise, and complementary therapies after primary treatment for cancer
Jones, L. W., & Demark‐Wahnefried, W. (2006) · The Lancet Oncology · doi:10.1016/s1470-2045(06)70976-7 · Cited by 177 · see citing works
Serum 25-hydroxyvitamin D levels and survival in colorectal and breast cancer patients: Systematic review and meta-analysis of prospective cohort studies
Maalmi, H., Ordóñez-Mena, J. M., Schöttker, B., & Brenner, H. (2014) · European Journal of Cancer · doi:10.1016/j.ejca.2014.02.006 · Cited by 164 · see citing works
Dietary Lignans: Potential Role in Cancer Prevention
Webb, A., & McCullough, M. L. (2005) · Nutrition and Cancer · doi:10.1207/s15327914nc5102_1 · Cited by 161 · see citing works
High-fiber oat cereal compared with wheat cereal consumption favorably alters LDL-cholesterol subclass and particle numbers in middle-aged and older men.
Davy, B. M., Davy, K. P., Ho, R. C., Beske, S. D., Davrath, L. R., & Melby, C. L. (2002) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/76.2.351 · Cited by 161 · see citing works
Molecular pathways: gene-environment interactions regulating dietary fiber induction of proliferation and apoptosis via butyrate for cancer prevention
Bultman, S. J. (2014) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-13-2483 · Cited by 157 · see citing works
Dietary Fiber Intake Reduces Risk for Colorectal Adenoma: A Meta-analysis
Ben, Q., Sun, Y., Chai, R., Qian, A., Xu, B., & Yuan, Y. (2014) · Gastroenterology · doi:10.1053/j.gastro.2013.11.003 · Cited by 156 · see citing works
Sodium butyrate and tributyrin induce in vivo growth inhibition and apoptosis in human prostate cancer
Kuefer, R., Hofer, M. D., Altug, V., Zorn, C. S., Genze, F., Kunzi‐Rapp, K., Hautmann, R. E., & Gschwend, J. E. (2004) · British Journal of Cancer · doi:10.1038/sj.bjc.6601510 · Cited by 152 · see citing works
Dietary Phytoestrogen Intake Is Associated with Reduced Colorectal Cancer Risk
Cotterchio, M., Boucher, B. A., Manno, M., Gallinger, S., Okey, A. B., & Harper, P. A. (2006) · Journal of Nutrition · doi:10.1093/jn/136.12.3046 · Cited by 149 · see citing works
Dietary fiber intake and total mortality: A meta-analysis of prospective cohort studies
Kim, Y., & Je, Y. (2014) · American Journal of Epidemiology · doi:10.1093/aje/kwu174 · Cited by 141 · see citing works
Revisit dietary fiber on colorectal cancer: butyrate and its role on prevention and treatment
Encarnação, J. C., Abrantes, A. M., Pires, A. S., & Botelho, M. F. (2015) · Cancer and Metastasis Reviews · doi:10.1007/s10555-015-9578-9 · Cited by 126 · see citing works
Pragmatic Lifestyle Intervention in Patients Recovering From Colon Cancer: A Randomized Controlled Pilot Study
Bourke, L., Thompson, G., Gibson, D. J., Daley, A., Crank, H., Adam, I., Shorthouse, A., & Saxton, J. (2011) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2010.12.020 · Cited by 118 · see citing works
Anticolorectal cancer activity of the omega-3 polyunsaturated fatty acid eicosapentaenoic acid.
Cockbain, A. J., Volpato, M., Race, A. D., Munarini, A., Fazio, C., Belluzzi, A., Loadman, P. M., Toogood, G. J., & Hull, M. A. (2014) · Gut · doi:10.1136/gutjnl-2013-306445 · Cited by 115 · see citing works
Marine ω-3 polyunsaturated fatty acid intake and survival after colorectal cancer diagnosis
Song, M., Zhang, X., Meyerhardt, J. A., Giovannucci, E. L., Ogino, S., Fuchs, C. S., & Chan, A. T. (2016) · Gut · doi:10.1136/gutjnl-2016-311990 · Cited by 112 · see citing works
Self-citation
Intake of dietary fiber, especially from cereal foods, is associated with lower incidence of colon cancer in the HELGA cohort.
Hansen, L., Skeie, G., Landberg, R., Lund, E., Palmqvist, R., Johansson, I., Dragsted, L. O., Egeberg, R., Johnsen, N. F., Christensen, J., et al. (2012) · International Journal of Cancer · doi:10.1002/ijc.26381 · Cited by 92 · see citing works
Butyric acid prodrugs are histone deacetylase inhibitors that show antineoplastic activity and radiosensitizing capacity in the treatment of malignant gliomas
Entin‐Meer, M., Rephaeli, A., Yang, X., Nudelman, A., VandenBerg, S. R., & Haas-Kogan, D. A. (2005) · Molecular Cancer Therapeutics · doi:10.1158/1535-7163.mct-05-0087 · Cited by 84 · see citing works
PROTECTIVE EFFECT OF DIETARY FIBRE AGAINST CHEMICALLY INDUCED BOWEL TUMOURS IN RATS
FLEISZER, D. M., MacFarlane, J. K., Murray, D. J., & Brown, R. A. (1978) · The Lancet · doi:10.1016/s0140-6736(78)92885-4 · Cited by 83 · see citing works
Association of angiopoietin-2, C-reactive protein and markers of obesity and insulin resistance with survival outcome in colorectal cancer.
Volkova, E., Willis, J. A., Wells, J. E., Robinson, B. A., Dachs, G. U., & Currie, M. J. (2011) · British Journal of Cancer · doi:10.1038/sj.bjc.6606005 · Cited by 78 · see citing works
Metabolic Dysfunction, Obesity, and Survival Among Patients With Early-Stage Colorectal Cancer
Feliciano, E. M. C., Kroenke, C. H., Meyerhardt, J. A., Prado, C. M. M., Bradshaw, P. T., Dannenberg, A. J., Kwan, M. L., Xiao, J., Quesenberry, C. P., Weltzien, E. K., et al. (2016) · Journal of Clinical Oncology · doi:10.1200/jco.2016.67.4473 · Cited by 78 · see citing works
Self-citation
Obesity and Energy Balance in GI Cancer
Brown, J. C., & Meyerhardt, J. A. (2016) · Journal of Clinical Oncology · doi:10.1200/jco.2016.66.8699 · Cited by 62 · see citing works
Self-citation
Cloning the full-length cDNA for rat connective tissue growth factor: Implications for skeletal development
Xu, J., Smock, S. L., Safadi, F. F., Rosenzweig, A. B., Odgren, P. R., Marks, S. C., Owen, T. A., & Popoff, S. N. (2000) · Journal of Cellular Biochemistry · doi:10.1002/(sici)1097-4644(20000401)77:1 · Cited by 48 · see citing works
A randomized controlled trial of physical activity, dietary habit, and distress management with the Leadership and Coaching for Health (LEACH) program for disease-free cancer survivors
Yun, Y. H., Kim, Y. A., Lee, M. K., Sim, J. A., Nam, B.-H., Kim, S., Lee, E. S., Noh, D.-Y., Lim, J.-Y., Kim, S., et al. (2017) · BMC Cancer · doi:10.1186/s12885-017-3290-9 · Cited by 47 · see citing works
Synergistic efficacy of 3n-butyrate and 5-fluorouracil in human colorectal cancer xenografts via modulation of DNA synthesis
Bras-Gonçalves, R., Pocard, M. D., Bichât, F., Pinieux, G. D. B. D., Pandrea, I., Arvelo, F. A., Ronco, G., Villa, P., Coquelle, A., Milano, G. A., et al. (2001) · Gastroenterology · doi:10.1053/gast.2001.22440 · Cited by 43 · see citing works
Dietary fiber enhances TGF-β signaling and growth inhibition in the gut
Cao, Y., Gao, X., Zhang, W., Zhang, G., Nguyen, A. K., Liu, X.-H., Jiménez, F., Cox, C. S., Townsend, C. M., & Ko, T. C. (2011) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00362.2010 · Cited by 32 · see citing works

Flagged first, then by citations

3 of the 71 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

Prosky, 1985, Determination of total dietary fiber in foods and food products., J Assoc Off Anal Chem, 68, 677

Sorted by citations

Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies
Keum, N., & Giovannucci, E. L. (2019) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-019-0189-8 · Cited by 2,690 · see citing works
Self-citation
Influence of the Gut Microbiome, Diet, and Environment on Risk of Colorectal Cancer
Song, M., Chan, A. T., & Sun, J. (2020) · Gastroenterology · doi:10.1053/j.gastro.2019.06.048 · Cited by 752 · see citing works
Self-citation
Colorectal Cancer and Nutrition
Thanikachalam, K., & Khan, G. N. (2019) · Nutrients · doi:10.3390/nu11010164 · Cited by 732 · see citing works
Clostridium butyricum, a butyrate-producing probiotic, inhibits intestinal tumor development through modulating Wnt signaling and gut microbiota
Chen, D., Jin, D., Huang, S., Wu, J., Xu, M., Liu, T., Dong, W., Liu, X., Wang, S., Zhong, W., et al. (2019) · Cancer Letters · doi:10.1016/j.canlet.2019.11.019 · Cited by 495 · see citing works
The Immunomodulatory Functions of Butyrate
Siddiqui, M. T., & Cresci, G. A. (2021) · Journal of Inflammation Research · doi:10.2147/jir.s300989 · Cited by 381 · see citing works
Environmental Factors, Gut Microbiota, and Colorectal Cancer Prevention
Song, M., & Chan, A. T. (2019) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2018.07.012 · Cited by 355 · see citing works
Self-citation
Whole Fruits and Fruit Fiber Emerging Health Effects
Dreher, M. L. (2018) · Nutrients · doi:10.3390/nu10121833 · Cited by 378 · see citing works
The Role of the Gut Microbiome in Colorectal Cancer Development and Therapy Response
Sánchez‐Alcoholado, L., Ramos‐Molina, B., Otero, A. P., Laborda-Illanes, A., Ordóñez, R., Medina, J. A., Gómez‐Millán, J., & Queipo‐Ortuño, M. I. (2020) · Cancers · doi:10.3390/cancers12061406 · Cited by 338 · see citing works
Therapeutic Benefits and Dietary Restrictions of Fiber Intake: A State of the Art Review
Ioniță-Mîndrican, C.-B., Ziani, K., Mititelu, M., Oprea, E., Neacșu, S. M., Moroșan, E., Dumitrescu, D. E., Roșca, A. C., Drăgănescu, D., & Negrei, C. (2022) · Nutrients · doi:10.3390/nu14132641 · Cited by 281 · see citing works
High fat diet, gut microbiome and gastrointestinal cancer
Tong, Y., Gao, H., Qi, Q., Liu, X., Li, J., Gao, J., Li, P., Wang, Y., Du, L., & Wang, C. (2021) · Theranostics · doi:10.7150/thno.56157 · Cited by 205 · see citing works
Current Prevalence of Major Cancer Risk Factors and Screening Test Use in the United States: Disparities by Education and Race/Ethnicity
Sauer, A. G., Siegel, R. L., Jemal, A., & Fedewa, S. A. (2019) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-18-1169 · Cited by 169 · see citing works
NUTRITIONAL VALUE OF WHEAT, TRITICALE, BARLEY AND OAT GRAINS
Biel, W., Kazimierska, K., & Bashutska, U. (2020) · Acta Scientiarum Polonorum. Zootechnica · doi:10.21005/asp.2020.19.2.03 · Cited by 117 · see citing works
Tea polyphenols and their chemopreventive and therapeutic effects on colorectal cancer
Wang, S.-T., Cui, W., Pan, D., Jiang, M., Chang, B., & Sang, L.-X. (2020) · World Journal of Gastroenterology · doi:10.3748/wjg.v26.i6.562 · Cited by 110 · see citing works
Integrated In Vitro and In Silico Modeling Delineates the Molecular Effects of a Synbiotic Regimen on Colorectal-Cancer-Derived Cells
Greenhalgh, K., Ramiro‐Garcia, J., Heinken, A., Ullmann, P., Bintener, T., Pacheco, M. P., Bagińska, J., Shah, P., Frachet, A., Halder, R., et al. (2019) · Cell Reports · doi:10.1016/j.celrep.2019.04.001 · Cited by 96 · see citing works
Gut Microbiota and Colorectal Cancer Development: A Closer Look to the Adenoma-Carcinoma Sequence
Vacante, M., Ciuni, R., Basile, F., & Biondi, A. (2020) · Biomedicines · doi:10.3390/biomedicines8110489 · Cited by 96 · see citing works
Enterotypical Prevotella and three novel bacterial biomarkers in preoperative stool predict the clinical outcome of colorectal cancer
Huh, J.-W., Kim, M. J., Kim, J., Lee, H. G., Ryoo, S. B., Ku, J.-L., Jeong, S.-Y., Park, K. J., Kim, J. F., Kim, J. F., et al. (2022) · Microbiome · doi:10.1186/s40168-022-01388-8 · Cited by 74 · see citing works
Health Benefits of Dietary Fiber for the Management of Inflammatory Bowel Disease
Yusuf, K., Saha, S., & Umar, S. (2022) · Biomedicines · doi:10.3390/biomedicines10061242 · Cited by 73 · see citing works
Colorectal Cancer and Diet
Zhou, E., & Rifkin, S. B. (2021) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2020.10.012 · Cited by 72 · see citing works
Dietary Risk-Related Colorectal Cancer Burden: Estimates From 1990 to 2019
Deng, Y., Wei, B., Zhai, Z., Zheng, Y., Yao, J., Wang, S., Xiang, D., Hu, J., Ye, X., Yang, S., et al. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.690663 · Cited by 70 · see citing works
The Potential Role of Exercise and Nutrition in Harnessing the Immune System to Improve Colorectal Cancer Survival
Song, M., & Chan, A. T. (2018) · Gastroenterology · doi:10.1053/j.gastro.2018.07.038 · Cited by 67 · see citing works
Self-citation
Diet-microbiome interactions in cancer treatment: Opportunities and challenges for precision nutrition in cancer
Greathouse, K. L., Wyatt, M., Johnson, A. J., Toy, E. P., Khan, J., Dunn, K., Clegg, D. J., & Reddy, S. (2022) · Neoplasia · doi:10.1016/j.neo.2022.100800 · Cited by 65 · see citing works
Plant-Based Diets and Cancer Prognosis: a Review of Recent Research
Hardt, L., Mahamat‐Saleh, Y., Aune, D., & Schlesinger, S. (2022) · Current Nutrition Reports · doi:10.1007/s13668-022-00440-1 · Cited by 64 · see citing works
Whole Grain Consumption for the Prevention and Treatment of Breast Cancer
Xie, M., Liu, J., Tsao, R., Wang, Z., Sun, B., & Wang, J. (2019) · Nutrients · doi:10.3390/nu11081769 · Cited by 63 · see citing works
Carbohydrate Nutrition and the Risk of Cancer
Vieytes, C. A. M., Taha, H. M., Burton-Obanla, A. A., Douglas, K. G., & Arthur, A. E. (2019) · Current Nutrition Reports · doi:10.1007/s13668-019-0264-3 · Cited by 61 · see citing works
Impact of bariatric surgery on cancer risk reduction
Bruno, D. S., & Berger, N. A. (2020) · Annals of Translational Medicine · doi:10.21037/atm.2019.09.26 · Cited by 61 · see citing works
Nutritional Treatment of Patients with Colorectal Cancer
Lewandowska, A., Religioni, U., Czerw, A. I., Deptała, A., Karakiewicz, B., Partyka, O., Pajewska, M., Sygit, K., Cipora, E., Kmieć, K., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19116881 · Cited by 59 · see citing works
Microbiota-Associated Metabolites and Related Immunoregulation in Colorectal Cancer
Chen, Y., & Chen, Y. (2021) · Cancers · doi:10.3390/cancers13164054 · Cited by 54 · see citing works
Navy Beans Impact the Stool Metabolome and Metabolic Pathways for Colon Health in Cancer Survivors
Baxter, B. A., Oppel, R. C., & Ryan, E. P. (2018) · Nutrients · doi:10.3390/nu11010028 · Cited by 54 · see citing works
Dietary fiber: Still alive
Pérez‐Jiménez, J. (2023) · Food Chemistry · doi:10.1016/j.foodchem.2023.138076 · Cited by 53 · see citing works
Application of Big Data analysis in gastrointestinal research
Cheung, K. S., Leung, W. K., & Seto, W. (2019) · World Journal of Gastroenterology · doi:10.3748/wjg.v25.i24.2990 · Cited by 53 · see citing works
Association of Dietary Fiber, Composite Dietary Antioxidant Index and Risk of Death in Tumor Survivors: National Health and Nutrition Examination Survey 2001–2018
Tan, Z., Meng, Y., Li, L., Wu, Y., Liu, C., Dong, W., & Chen, C. (2023) · Nutrients · doi:10.3390/nu15132968 · Cited by 52 · see citing works
Tripartite relationship between gut microbiota, intestinal mucus and dietary fibers: towards preventive strategies against enteric infections
Sauvaitre, T., Etienne‐Mesmin, L., Sivignon, A., Mosoni, P., Courtin, C. M., de Wiele, T. V., & Blanquet‐Diot, S. (2020) · FEMS Microbiology Reviews · doi:10.1093/femsre/fuaa052 · Cited by 53 · see citing works
The Facts about Food after Cancer Diagnosis: A Systematic Review of Prospective Cohort Studies
Rinninella, E., Mele, M. C., Cintoni, M., Raoul, P. C., Ianiro, G., Salerno, L., Pozzo, C., Bria, E., Muscaritoli, M., Molfino, A., et al. (2020) · Nutrients · doi:10.3390/nu12082345 · Cited by 51 · see citing works
The Impact of Whole Grain Intake on Gastrointestinal Tumors: A Focus on Colorectal, Gastric, and Esophageal Cancers
Tullio, V., Gasperi, V., Catani, M. V., & Savini, I. (2020) · Nutrients · doi:10.3390/nu13010081 · Cited by 51 · see citing works
Seaweeds’ nutraceutical and biomedical potential in cancer therapy: a concise review
Cotas, J., Pacheco, D., Gonçalves, A. M. M., silva, P. H. D. S., Carvalho, L. G., & Pereira, L. (2021) · Journal of Cancer Metastasis and Treatment · doi:10.20517/2394-4722.2020.134 · Cited by 50 · see citing works
Survival of Colorectal Cancer Patients With Diabetes Mellitus: A Meta-Analysis
Petrelli, F., Ghidini, M., Rausa, E., Ghidini, A., Cabiddu, M., Borgonovo, K., Ghilardi, M., Parati, M. C., Pietrantonio, F., Sganzerla, P., et al. (2020) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2020.06.009 · Cited by 46 · see citing works
Dietary Fat and Sugar in Promoting Cancer Development and Progression
Goncalves, M. D., Hopkins, B. D., & Cantley, L. C. (2019) · Annual Review of Cancer Biology · doi:10.1146/annurev-cancerbio-030518-055855 · Cited by 45 · see citing works
Diet, nutrient supply, and tumor immune responses
McIntyre, C., Temesgen, A., & Lynch, L. (2023) · Trends in cancer · doi:10.1016/j.trecan.2023.06.003 · Cited by 43 · see citing works
Role of the gut microbiota in tumorigenesis and treatment
Liu, Q., Yang, Y., Pan, M., Yang, F., Yu, Y., & Qian, Z. (2024) · Theranostics · doi:10.7150/thno.91700 · Cited by 43 · see citing works
Anticancer potential of algae-derived metabolites: recent updates and breakthroughs
Sharma, R., Mondal, A. S., & Trivedi, N. (2023) · Future Journal of Pharmaceutical Sciences · doi:10.1186/s43094-023-00492-2 · Cited by 40 · see citing works
Ginseng polysaccharides ameliorate colorectal tumorigenesis through Lachnospiraceae-mediated immune modulation.
Zong, G.-F., Deng, R., Pan, Y.-H., Liu, M., Zhu, H.-Z., Tao, R.-Z., Shan, Y.-L., Wei, Z.-H., & Lu, Y. (2025) · International Journal of Biological Macromolecules · doi:10.1016/j.ijbiomac.2025.142015 · Cited by 41 · see citing works
Calcium Intake and Survival after Colorectal Cancer Diagnosis
Yang, W., Ma, Y., Smith‐Warner, S. A., Song, M., Wu, K., Wang, M., Chan, A. T., Ogino, S., Fuchs, C. S., Poylin, V. Y., et al. (2018) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-18-2965 · Cited by 38 · see citing works
Self-citation
Diet-microbiome interactions in cancer
Abdeen, S. K., Mastandrea, I., Stinchcombe, N., Puschhof, J., & Elinav, E. (2025) · Cancer Cell · doi:10.1016/j.ccell.2025.03.013 · Cited by 36 · see citing works
Short-chain fatty acids play a positive role in colorectal cancer
Liu, G., Tang, J., Zhou, J., & Dong, M. (2024) · Discover Oncology · doi:10.1007/s12672-024-01313-5 · Cited by 37 · see citing works
Functional link between plasma membrane spatiotemporal dynamics, cancer biology, and dietary membrane-altering agents
Erazo‐Oliveras, A., Fuentes, N. R., Wright, R. C., & Chapkin, R. S. (2018) · Cancer and Metastasis Reviews · doi:10.1007/s10555-018-9733-1 · Cited by 38 · see citing works
Low-Carbohydrate Diet Score and Macronutrient Intake in Relation to Survival After Colorectal Cancer Diagnosis
Song, M., Wu, K., Meyerhardt, J. A., Yilmaz, Ö. H., Wang, M., Ogino, S., Fuchs, C. S., Giovannucci, E. L., & Chan, A. T. (2018) · JNCI Cancer Spectrum · doi:10.1093/jncics/pky077 · Cited by 37 · see citing works
Self-citation
Possible role of nutrition in the prevention of inflammatory bowel disease–related colorectal cancer: A focus on human studies
Cassotta, M., Cianciosi, D., Giuseppe, R. D., Navarro‐Hortal, M. D., Díaz, Y. A., Forbes-Hernández, T. Y., Pifarré, K. T., Barrera, A. E. P., Grosso, G., Xiao, J., et al. (2023) · Nutrition · doi:10.1016/j.nut.2023.111980 · Cited by 34 · see citing works
Lactobacillus fermentum V3 ameliorates colitis-associated tumorigenesis by modulating the gut microbiome.
Chou, Y.-C., Ho, P.-Y., Chen, W.-J., Wu, S.-H., & Pan, M. (2020) · PubMed Central · Cited by 34 · see citing works
Associations of Japanese food intake with survival of stomach and colorectal cancer: A prospective patient cohort study
Minami, Y., Kanemura, S., Oikawa, T., Suzuki, S., Hasegawa, Y., Nishino, Y., Fujiya, T., & Miura, K. (2020) · Cancer Science · doi:10.1111/cas.14459 · Cited by 34 · see citing works
Dysregulation of cellular membrane homeostasis as a crucial modulator of cancer risk
Erazo‐Oliveras, A., Muñoz‐Vega, M., Salinas, M. L., Wang, X., & Chapkin, R. S. (2022) · FEBS Journal · doi:10.1111/febs.16665 · Cited by 37 · see citing works
Gut microbiota interactions with antitumor immunity in colorectal cancer: From understanding to application
Zhuang, Y.-P., Zhou, H., Chen, H., Zheng, M.-Y., Liang, Y., Gu, Y.-T., Li, W., Qiu, W., & Zhou, H. (2023) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2023.115040 · Cited by 33 · see citing works
Endogenous sex hormones and colorectal cancer survival among men and women
Yang, W., Giovannucci, E. L., Hankinson, S. E., Chan, A. T., Ma, Y., Wu, K., Fuchs, C. S., Lee, I.-M. M., Sesso, H. D., Lin, J., et al. (2019) · International Journal of Cancer · doi:10.1002/ijc.32844 · Cited by 33 · see citing works
Self-citation
Effect of inulin-type fructans in patients undergoing cancer treatments: A systematic review
Mazraeh, R., Azizi-Soleiman, F., Jazayeri, S. M. H. M., & Noori, S. M. A. (2019) · Pakistan Journal of Medical Sciences · doi:10.12669/pjms.35.2.701 · Cited by 31 · see citing works
Dietary intake of branched‐chain amino acids and survival after colorectal cancer diagnosis
Long, L., Yang, W., Liu, L., Tobias, D. K., Katagiri, R., Wu, K., Jin, L., Zhang, F., Luo, X., Liu, X., et al. (2020) · International Journal of Cancer · doi:10.1002/ijc.33449 · Cited by 29 · see citing works
Self-citation
Association between dried fruit intake and pan-cancers incidence risk: A two-sample Mendelian randomization study
Chen, J., Li, R., Deng, T., Lin, Z., Li, H., Yang, Y., Su, Q., Wang, J., Yang, Y., Wang, J., et al. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.899137 · Cited by 29 · see citing works
Dietary fiber intake and mortality in a Mediterranean population: the “Seguimiento Universidad de Navarra” (SUN) project
Dominguez, L. J., Bes‐Rastrollo, M., Toledo, E., Gea, A., Fresán, U., Barbagallo, M., & Martínez‐González, M. Á. (2018) · European Journal of Nutrition · doi:10.1007/s00394-018-1846-3 · Cited by 28 · see citing works
Longitudinal associations of fiber, vegetable, and fruit intake with quality of life and fatigue in colorectal cancer survivors up to 24 months posttreatment
Kenkhuis, M., van Duijnhoven, F. J. B., van Roekel, E. H., Breedveld-Peters, J. J. L., Breukink, S. O., Janssen-Heijnen, M. L. G., Keulen, E. T. P., Mols, F., Weijenberg, M. P., & Bours, M. J. L. (2021) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqab360 · Cited by 28 · see citing works
The Crucial Roles of Diet, Microbiota, and Postbiotics in Colorectal Cancer
Kuru-Yaşar, R., & Üstün‐Aytekin, Ö. (2024) · Current Nutrition Reports · doi:10.1007/s13668-024-00525-z · Cited by 29 · see citing works
The global burden and trends analysis of early-onset colorectal cancer attributable to dietary risk factors in 204 countries and territories, 1990–2019: a secondary analysis for the global burden of disease study 2019
Su, J., Liang, Y., & He, X. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1384352 · Cited by 27 · see citing works
Personalized Nutrition in Disrupting Cancer — Proceedings From the 2017 American College of Nutrition Annual Meeting
Wallace, T. C., Bultman, S. J., D’Adamo, C. R., Daniel, C. R., Debelius, J. W., Ho, E., Eliassen, A. H., Lemanne, D., Mukherjee, P., Seyfried, T. N., et al. (2018) · Journal of the American College of Nutrition · doi:10.1080/07315724.2018.1500499 · Cited by 27 · see citing works
The Microbiota–Diet–Immunity Axis in Cancer Care: From Prevention to Treatment Modulation and Survivorship
Tini, S., Baima, J., Pigni, S., Antoniotti, V., Caputo, M., Palma, E. D., Cerbone, L., Grosso, F., Vecchia, M. L., Bona, E., et al. (2025) · Nutrients · doi:10.3390/nu17172898 · Cited by 27 · see citing works
Post-diagnostic reliance on plant-compared with animal-based foods and all-cause mortality in omnivorous long-term colorectal cancer survivors
Ratjen, I., Enderle, J., Burmeister, G., Koch, M., Nöthlings, U., Hampe, J., & Lieb, W. (2021) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqab061 · Cited by 26 · see citing works
Pharmacodynamic components and mechanisms of ginger (Zingiber officinale) in the prevention and treatment of colorectal cancer
Xiang, S., Jian, Q., Wu, C., Xu, Q., Li, J., Wang, C., Wang, R., Zhang, D., Lin, J., & Zheng, C. (2024) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2024.117733 · Cited by 25 · see citing works
Dietary intake of total vegetable, fruit, cereal, soluble and insoluble fiber and risk of all-cause, cardiovascular, and cancer mortality: systematic review and dose–response meta-analysis of prospective cohort studies
Yao, F., Ma, J., Cui, Y., Huang, C., Lu, R., Hu, F., Zhu, X., & Qin, P. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1153165 · Cited by 25 · see citing works
Drug–Microbiota Interaction in Colon Cancer Therapy: Impact of Antibiotics
Mohamed, A. A., Menon, H., Chulkina, M., Yee, N. S., & Pinchuk, I. V. (2021) · Biomedicines · doi:10.3390/biomedicines9030259 · Cited by 24 · see citing works
Fermented Dairy Food Intake and Risk of Colorectal Cancer: A Systematic Review and Meta-Analysis
Liang, Z., Song, X., Hu, J., Wu, R., Li, P., Dong, Z., Liang, L., & Wang, J. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.812679 · Cited by 24 · see citing works
Post‐diagnosis dietary factors, supplement use and colorectal cancer prognosis: A Global Cancer Update Programme ( CUP Global) systematic literature review and meta‐analysis
Chan, D. S. M., Cariolou, M., Markozannes, G., Balducci, K., Vieira, R. D. C. P. A., Kiss, S., Becerra‐Tomás, N., Aune, D., Greenwood, D. C., González‐Gil, E. M., et al. (2024) · International Journal of Cancer · doi:10.1002/ijc.34906 · Cited by 26 · see citing works
National Implementation of an Artificial Intelligence–Based Virtual Dietitian for Patients With Cancer
Buchan, M. L., Goel, K., Schneider, C., Steullet, V., Bratton, S. L., & Basch, E. (2024) · JCO Clinical Cancer Informatics · doi:10.1200/cci.24.00085 · Cited by 23 · see citing works
Dietary Intake in Association with All-Cause Mortality and Colorectal Cancer Mortality among Colorectal Cancer Survivors: A Systematic Review and Meta-Analysis of Prospective Studies
Hoang, T., Kim, H., & Kim, J. (2020) · Cancers · doi:10.3390/cancers12113391 · Cited by 23 · see citing works
Association between Dietary Fiber Intake and Mortality among Colorectal Cancer Survivors: Results from the Newfoundland Familial Colorectal Cancer Cohort Study and a Meta-Analysis of Prospective Studies
Zhao, J., Zhu, Y., Du, M., Wang, Y., Vallis, J., Parfrey, P. S., McLaughlin, J. R., Qi, X., & Wang, P. (2022) · Cancers · doi:10.3390/cancers14153801 · Cited by 23 · see citing works
Let food be thy medicine: the role of diet in colorectal cancer: a narrative review
Zheng, Y., Meng, L., Liu, H., Sun, L., Nie, Y., Wu, Q., Fan, D., & Li, M. (2022) · Journal of Gastrointestinal Oncology · doi:10.21037/jgo-22-32 · Cited by 22 · see citing works
Serum Concentration of Genistein, Luteolin and Colorectal Cancer Prognosis
Jiang, R., Poschet, G., Owen, R. W., Celik, M., Jansen, L., Hell, R., Hoffmeister, M., Brenner, H., & Chang-Claude, J. C. (2019) · Nutrients · doi:10.3390/nu11030600 · Cited by 21 · see citing works
The Association between Prebiotic Fiber Supplement Use and Colorectal Cancer Risk and Mortality in the Women's Health Initiative
Skiba, M. B., Kohler, L. N., Crane, T. E., Jacobs, E. T., Shadyab, A. H., Kato, I., Snetselaar, L. G., Qi, L., & Thomson, C. A. (2019) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-19-0326 · Cited by 21 · see citing works
Innovative approaches to integrating plant-based nutrition in clinical care: a path to better patient outcomes
Arslan, S., Aydın, A., Gerboğa, R., ARSLAN, H. B., Kırbıyık, K. B., Matar, A., Karabıyık, D., & Solak, E. (2024) · Clinical Science of Nutrition · doi:10.62210/clinscinutr.2024.93 · Cited by 20 · see citing works
Weighty matters: Unraveling the impact of obesity on colorectal cancer and nutritional interventions
Simancas‐Racines, D., Reytor-González, C., Frías-Toral, E., Katsanos, C. S., & Hidalgo, R. (2025) · Seminars in Cancer Biology · doi:10.1016/j.semcancer.2025.06.004 · Cited by 20 · see citing works
Components of the Fiber Diet in the Prevention and Treatment of IBD—An Update
Ferenc, K., Jarmakiewicz-Czaja, S., & Filip, R. (2022) · Nutrients · doi:10.3390/nu15010162 · Cited by 20 · see citing works
Ultra-processed food consumption and mortality among patients with stages I–III colorectal cancer: a prospective cohort study
Hang, D., Du, M., Wang, L., Wang, K., Fang, Z., Khandpur, N., Rossato, S. L., Steele, E. M., Chan, A. T., Hu, F. B., et al. (2024) · EClinicalMedicine · doi:10.1016/j.eclinm.2024.102572 · Cited by 20 · see citing works
Self-citation
Association of Diet Quality With Survival Among People With Metastatic Colorectal Cancer in the Cancer and Leukemia B and Southwest Oncology Group 80405 Trial
Blarigan, E. L. V., Zhang, S., Ou, F., Venlo, A., Ng, K., Atreya, C. E., Loon, K. V., Niedzwiecki, D., Giovannucci, E. L., Wolfe, E. G., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.23500 · Cited by 20 · see citing works
Self-citation
Prevalence and implications of pKs-positive Escherichia coli in colorectal cancer
de Souza, J. B., Campos, L. A. D. A., Palácio, S. B., de Castro, M. C. A. B., & Cavalcanti, I. M. F. (2024) · Life Sciences · doi:10.1016/j.lfs.2024.122462 · Cited by 20 · see citing works
Impact of Diet and Exercise on Colorectal Cancer
Lee, S., & Meyerhardt, J. A. (2022) · Hematology/Oncology Clinics of North America · doi:10.1016/j.hoc.2022.02.004 · Cited by 19 · see citing works
Self-citation
Dietary Walnuts Protect Against Obesity-Driven Intestinal Stem Cell Decline and Tumorigenesis
Guan, F., Tabrizian, T., Novaj, A., Nakanishi, M., Rosenberg, D. W., & Huffman, D. M. (2018) · Frontiers in Nutrition · doi:10.3389/fnut.2018.00037 · Cited by 19 · see citing works
Nutrient acquisition of gut microbiota: Implications for tumor immunity
Wang, Y., Huang, J., Tong, H., Jiang, Y., Yu, J., & Ma, X. (2025) · Seminars in Cancer Biology · doi:10.1016/j.semcancer.2025.06.003 · Cited by 18 · see citing works
Identification of Lifestyle Behaviors Associated with Recurrence and Survival in Colorectal Cancer Patients Using Random Survival Forests
van Zutphen, M., van Duijnhoven, F. J. B., Wesselink, E., Schrauwen, R. W. M., Kouwenhoven, E. A., van Halteren, H. K., de Wilt, J. H. W., Winkels, R. M., Kok, D. E. G., & Boshuizen, H. C. (2021) · Cancers · doi:10.3390/cancers13102442 · Cited by 18 · see citing works
Dietary Fat Intake after Colon Cancer Diagnosis in Relation to Cancer Recurrence and Survival: CALGB 89803 (Alliance)
Blarigan, E. L. V., Ou, F., Niedzwiecki, D., Zhang, S., Fuchs, C. S., Saltz, L. B., Mayer, R. J., Venook, A. P., Ogino, S., Song, M., et al. (2018) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-18-0487 · Cited by 18 · see citing works
Self-citation
Relationship between Dietary Fiber Intake and the Prognosis of Amytrophic Lateral Sclerosis in Korea
Yu, H., Kim, S. H., Noh, M., Lee, S.-G., & Park, Y. (2020) · Nutrients · doi:10.3390/nu12113420 · Cited by 18 · see citing works
Flavonoid intake and survival after diagnosis of colorectal cancer: a prospective study in 2 US cohorts
Shi, S., Wang, K., Zhong, R., Cassidy, A., Rimm, E. B., Nimptsch, K., Wu, K., Chan, A. T., Giovannucci, E. L., Ogino, S., et al. (2023) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.03.026 · Cited by 17 · see citing works
Self-citation
Associations Between Unprocessed Red Meat and Processed Meat With Risk of Recurrence and Mortality in Patients With Stage III Colon Cancer
Blarigan, E. L. V., Ou, F., Bainter, T. M., Fuchs, C. S., Niedzwiecki, D., Zhang, S., Saltz, L. B., Mayer, R. J., Hantel, A., Benson, A. B., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.0145 · Cited by 17 · see citing works
Self-citation
Variety of Fruit and Vegetables and Alcohol Intake are Associated with Gut Microbial Species and Gene Abundance in Colorectal Cancer Survivors
Kyaw, T. S., Upadhyay, V., Tolstykh, I. V., Loon, K. V., Laffan, A., Stanfield, D., Gempis, D., Kenfield, S. A., Chan, J. M., Piawah, S., et al. (2023) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.07.011 · Cited by 16 · see citing works
The Role of p53-Mediated Signaling in the Therapeutic Response of Colorectal Cancer to 9F, a Spermine-Modified Naphthalene Diimide Derivative
Gao, L., Ge, C., Wang, S., Xu, X., Feng, Y., Li, X., Wang, C., Wang, Y., Dai, F., & Xie, S. (2020) · Cancers · doi:10.3390/cancers12030528 · Cited by 16 · see citing works
Integrative Treatment for Colorectal Cancer: A Comprehensive Approach
Block, K. I., Block, P. B., & Gyllenhaal, C. (2018) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2018.0125 · Cited by 16 · see citing works
Diet and bowel symptoms among colon cancer survivors
Borre, M., Fassov, J., Juul, T., Laurberg, S., Christensen, P., Bräuner, A. B., Thorlacius‐Ussing, O., Lauritzen, M. B., Drewes, A. M., Faaborg, P. M., et al. (2022) · Acta Oncologica · doi:10.1080/0284186x.2022.2101901 · Cited by 15 · see citing works
Multi-Disciplinary Management in Rectal Cancer Survivorship: A Clinical Practice Review
Chan, H., Savoie, M. B., Munir, A. Z., Moslehi, J. J., Anwar, M., Laffan, A., Rowen, T. S., Salmon, R., Varma, M. G., & Loon, K. V. (2023) · Journal of Gastrointestinal Cancer · doi:10.1007/s12029-022-00885-1 · Cited by 15 · see citing works
Global trends and projections of colorectal, esophageal and stomach cancer burden among youth associated with diet: A analysis of 204 countries and territories from 1990 to 2019 and until 2040
He, K., & Gong, G. (2024) · Translational Oncology · doi:10.1016/j.tranon.2024.101984 · Cited by 15 · see citing works
The Burden of Colorectal Cancer Attributable to Diet Low in Fiber from 1990 to 2019: A Global, Regional and National Analysis
Xie, W., Zuo, J., Ma, Z., Yu, W., Hu, Z., Yang, T., & Song, Z. (2022) · The journal of nutrition health & aging · doi:10.1007/s12603-022-1865-x · Cited by 14 · see citing works
Diet-Wide Association, Genetic Susceptibility and Colorectal Cancer Risk: A Prospective Cohort Study
Jin, D., Lu, Y. Y., Wu, W., Jiang, F., Li, Z., Xu, L., Zhang, R., Li, X., & Chen, D. (2023) · Nutrients · doi:10.3390/nu15224801 · Cited by 14 · see citing works
Higher dietary fiber intake associated with better survival in male but not female cancer patients: Evidence from National Health and Nutrition Examination Survey 1999–2014
Hong, W., Ying, H., Wang, X., Liu, L., Shen, X., & Shan, Y. (2023) · Nutrition · doi:10.1016/j.nut.2023.112035 · Cited by 12 · see citing works
Vitamin C intake and colorectal cancer survival according to KRAS and BRAF mutation: a prospective study in two US cohorts
Shi, S., Wang, K., Ugai, T., Giannakis, M., Cazaubiel, J., Chan, A. T., Giovannucci, E. L., Nowak, J. A., Meyerhardt, J. A., Ogino, S., et al. (2023) · British Journal of Cancer · doi:10.1038/s41416-023-02452-2 · Cited by 12 · see citing works
Self-citation
Deciphering the impact of dietary habits and behavioral patterns on colorectal cancer
Yuan, Q., Liu, J., Wang, X., Du, C., Zhang, Y., Lin, L., Wang, C., & Hong, Z. (2025) · International Journal of Surgery · doi:10.1097/js9.0000000000002229 · Cited by 12 · see citing works
Association of dietary fiber intake with metabolic syndrome among adult cancer survivors: a population-based cross-sectional study
Kim, K., & Chang, Y.-J. (2021) · Scientific Reports · doi:10.1038/s41598-021-91312-1 · Cited by 12 · see citing works
Butyrate-InducedIn VitroColonocyte Differentiation Network Model IdentifiesITGB1, SYK, CDKN2A, CHAF1A,andLRP1as the Prognostic Markers for Colorectal Cancer Recurrence
Dasgupta, N., Thakur, B. K., Chakraborty, A., & Das, S. (2018) · Nutrition and Cancer · doi:10.1080/01635581.2018.1540715 · Cited by 12 · see citing works

Association between Dietary Fiber Intake and Mortality among Colorectal Cancer Survivors: Results from the Newfoundland Familial Colorectal Cancer Cohort Study and a Meta-Analysis of Prospective Studies
Zhao, J., Zhu, Y., Du, M., Wang, Y., Vallis, J., Parfrey, P. S., McLaughlin, J. R., Qi, X., & Wang, P. (2022) · Cancers · doi:10.3390/cancers14153801 · Cited by 23 · see citing works
Bowel-Related Symptoms and Dietary Fiber Intake in Colorectal Cancer Survivors
Klaassen‐Dekker, N., Witteman, B. J. M., van Heek, N. T., Kruyt, F. M., Valgaeren, E., Gootjes, E. C., Rütten, H., Veer, P. V. ’., Winkels, R. M., van Duijnhoven, F. J. B., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.42147 · Cited by 4 · see citing works
The Impact of Dietary Intake on Mortality Risk in Colorectal Cancer Survivors
Chow, E. (2020) · ScholarWorks (Walden University)
Association Between Coffee Intake After Diagnosis of Colorectal Cancer and Reduced Mortality
Hu, Y., Ding, M., Yuan, C., Wu, K., Smith-Warner, S. A., Hu, F. B., Chan, A. T., Meyerhardt, J. A., Ogino, S., Fuchs, C. S., et al. (2018) · Gastroenterology · doi:10.1053/j.gastro.2017.11.010 · Cited by 75 · see citing works
Self-citation
Fiber intake and total and cause-specific mortality in the European Prospective Investigation into Cancer and Nutrition cohort
Chuang, S., Norat, T., Murphy, N., Olsen, A., Tjønneland, A. M., Overvad, K., Boutron‐Ruault, M., Perquier, F., Dartois, L., Kaaks, R., et al. (2012) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.111.028415 · Cited by 141 · see citing works

Authors: Song, M., Wu, K., Meyerhardt, J. A., Ogino, S., Wang, M., Fuchs, C. S., Giovannucci, E. L., & Chan, A. T.
Affiliations: Harvard University (US)
Brigham and Women's Hospital (US)
Yale Cancer Center (US)
Broad Institute (US)
Corresponding author: Chan, Andrew T.
ORCID: Song, Mingyang
Wu, Kana
Meyerhardt, Jeffrey A.
Ogino, Shuji
Wang, Molin
Fuchs, Charles S.
Giovannucci, Edward L.
Chan, Andrew T.
Venue: JAMA Oncology
Publisher: American Medical Association (AMA)
Published: 2018-01-01
Volume: 4
Issue: 1
Pages: 71
ISSN: 2374-2437 (ISSN-L)
DOI: 10.1001/jamaoncol.2017.3684
PMC: PMC5776713
OpenAlex: W2766404639
Cited by: 197
References: 71
Citations by year: 2026: 13 · 2025: 25 · 2024: 25 · 2023: 24 · 2022: 29 · 2021: 20 · 2020: 25 · 2019: 17 · 2018: 19
FWCI: 15.64
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: JAMA Oncology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (UL1TR001863)
National Cancer Institute (R01CA176272, P50CA127003, R01CA202704, R01CA151993, R01CA118553, R01CA137178, R35CA197735, P01CA087969, R01CA169141, P01CA055075, UM1CA186107, UM1CA167552, U01CA176726, U01CA167552)
National Institute of Diabetes and Digestive and Kidney Diseases (K24DK098311)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
Keywords: dietary fiber intake, colorectal cancer, cancer survivors, mortality, colorectal cancer-specific mortality, all-cause mortality, cereal fiber, whole grains, Nurses' Health Study, Health Professionals Follow-up Study, healthcare workers
MeSH terms: Cancer Survivors, Adult, Aged, Diet Surveys, Dietary Fiber, Eating, Feeding Behavior, Female, Follow-Up Studies, Health Occupations, Humans, Male, Middle Aged, Prospective Studies, Colorectal Neoplasms, Cohort Studies

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Fiber Intake and Survival After Colorectal Cancer Diagnosis

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Related

Record

About these checks