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Cited by 26Nutritional Studies and DietColorectal Cancer Screening and DetectionPhytochemicals and Antioxidant Activities

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Different types of fruit intake and colorectal cancer risk: A meta-analysis of observational studies

Open access
Wu, Zhen-Ying, Chen, Jia-Li, Li, Han, Su, Ke, Han, Yun-Wei·2023·World Journal of Gastroenterology

Abstract

BACKGROUND: Multiple studies investigating the relationship between intake of different types of fruit and colorectal cancer (CRC) risk have yielded inconsistent results. AIM: To perform a meta-analysis of existing studies to assess the association between the intake of different kinds of fruit and the incidence of CRC. METHODS: We searched online literature databases including PubMed, Embase, WOS, and Cochrane Library for relevant articles available up to August 2022. With data extracted from observational studies, odds ratios (ORs) with 95% confidence intervals (CIs) were assessed using random-effects models. A funnel plot and Egger's test were used to determine publication bias. Furthermore, subgroup analysis and dose-response analysis were performed. All analyses were conducted using R (version 4.1.3). RESULTS: < 0.001), with the risk minimized around 120 g/d (OR = 0.85), while no significant dose-response correlation was observed after continued increase in intake. CONCLUSION: We found that a higher intake of citrus, apples, watermelon, and kiwi was negatively associated with the risk of CRC, while the intake of other types of fruits were not significantly associated with CRC. Citrus intake showed a non-linear dose-response relationship with the risk of CRC. This meta-analysis provides further evidence that a higher intake of specific types of fruit is effective in preventing the occurrence of CRC.

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Figure 1 PRISMA flow chart of literature search and selection. RR: Relative risk; OR: Odds ratio; CI: Confidence intervals.
Figure 1 PRISMA flow chart of literature search and selection. RR: Relative risk; OR: Odds ratio; CI: Confidence intervals.CC BY-NC · PubMed Central
Figure 2 Meta-analysis of the risk of colorectal cancer in the highest vs lowest category of Citrus intake. F: Female, M: Male; W: Whites, A: African-Americans; C: Colon cancer, R: Rectal cancer. OR: Odds ratio; CI: Confidence intervals.
Figure 2 Meta-analysis of the risk of colorectal cancer in the highest vs lowest category of Citrus intake. F: Female, M: Male; W: Whites, A: African-Americans; C: Colon cancer, R: Rectal cancer. OR: Odds ratio; CI: Confidence intervals.CC BY-NC · PubMed Central
Figure 3 Subgroup analysis of the risk of colorectal cancer in the highest vs lowest category of Citrus intake by study type. F: Female; M: Male; W: Whites; A: African-Americans; C: Colon cancer; R: Rectal cancer; OR: Odds ratio; CI: Confidence intervals.
Figure 3 Subgroup analysis of the risk of colorectal cancer in the highest vs lowest category of Citrus intake by study type. F: Female; M: Male; W: Whites; A: African-Americans; C: Colon cancer; R: Rectal cancer; OR: Odds ratio; CI: Confidence intervals.CC BY-NC · PubMed Central
Figure 4 Subgroup analysis of the risk of colorectal cancer in the highest vs lowest category of Citrus intake by region of cancer. PC: Proximal colon cancer; DC: Distal colon cancer; C: Colon cancer; R: Rectal cancer; F: Female; M: Male; OR: Odds ratio; CI: Confidence intervals.
Figure 4 Subgroup analysis of the risk of colorectal cancer in the highest vs lowest category of Citrus intake by region of cancer. PC: Proximal colon cancer; DC: Distal colon cancer; C: Colon cancer; R: Rectal cancer; F: Female; M: Male; OR: Odds ratio; CI: Confidence intervals.CC BY-NC · PubMed Central
Figure 5 Subgroup analysis of the risk of colorectal cancer in the highest vs lowest category of Citrus intake by location. F: Female; M: Male; W: Whites; A: African-Americans; C: Colon cancer; R: Rectal cancer; OR: Odds ratio; CI: Confidence intervals.
Figure 5 Subgroup analysis of the risk of colorectal cancer in the highest vs lowest category of Citrus intake by location. F: Female; M: Male; W: Whites; A: African-Americans; C: Colon cancer; R: Rectal cancer; OR: Odds ratio; CI: Confidence intervals.CC BY-NC · PubMed Central
Figure 6 Subgroup analysis of the risk of colorectal cancer in the highest vs lowest category of Citrus intake by gender. F: Female; M: Male; OR: Odds ratio; CI: Confidence intervals.
Figure 6 Subgroup analysis of the risk of colorectal cancer in the highest vs lowest category of Citrus intake by gender. F: Female; M: Male; OR: Odds ratio; CI: Confidence intervals.CC BY-NC · PubMed Central
Figure 7 Meta-analysis of the risk of colorectal cancer in the highest vs lowest category of Apple intake. C: Colon cancer; R: Rectal cancer; OR: Odds ratio; CI: Confidence intervals.
Figure 7 Meta-analysis of the risk of colorectal cancer in the highest vs lowest category of Apple intake. C: Colon cancer; R: Rectal cancer; OR: Odds ratio; CI: Confidence intervals.CC BY-NC · PubMed Central
Figure 8 Nonlinear relation between Citrus fruit intake and the risk of colorectal cancer.
Figure 8 Nonlinear relation between Citrus fruit intake and the risk of colorectal cancer.CC BY-NC · PubMed Central
Figure 9 Funnel plot. A: Funnel plot of studies evaluating for the association between Citrus fruit intake and risk of colorectal cancer. Dotted lines on both sides indicate 95% pseudo-confidence intervals; B: Funnel plot of studies evaluating for the association between Apple intake and risk of colorectal cancer. OR: Odds ratio; CI: Confidence intervals.
Figure 9 Funnel plot. A: Funnel plot of studies evaluating for the association between Citrus fruit intake and risk of colorectal cancer. Dotted lines on both sides indicate 95% pseudo-confidence intervals; B: Funnel plot of studies evaluating for the association between Apple intake and risk of colorectal cancer. OR: Odds ratio; CI: Confidence intervals.CC BY-NC · PubMed Central

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References 73 · Cited by 26

Metadata

Authors
Wu, Z.-Y., Chen, J.-L., Li, H., Su, K., & Han, Y.-W.
Affiliations
Southwest Medical University (CN)
Venue
World Journal of Gastroenterology
Published
2023-05-07
Volume
29
Issue
17
Pages
2679-2700
ISSN
1007-9327 (ISSN-L)
OpenAlex
W4372348067
Cited by
26
References
73
Citations by year
2026: 5 · 2025: 10 · 2024: 11
FWCI
1.28
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • World Journal of Gastroenterology (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
  • Health Sciences › Medicine › Biochemistry (medical) › Phytochemicals and Antioxidant Activities
Keywords
colorectal cancer, fruit consumption, citrus, apple, watermelon, kiwi, cancer risk, dose-response relationship, cancer prevention, dietary factors
MeSH terms
Citrus, Diet, Fruit, Risk Factors, Colorectal Neoplasms

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CoChat. (2026). Citation check: Different types of fruit intake and colorectal cancer risk: A meta-analysis of observational studies. https://app.cochat.ai/papers/10.3748/wjg.v29.i17.2679
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Wu, Z.-Y., Chen, J.-L., Li, H., Su, K., & Han, Y.-W. (2023). Different types of fruit intake and colorectal cancer risk: A meta-analysis of observational studies. World Journal of Gastroenterology. https://doi.org/10.3748/wjg.v29.i17.2679

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