In recent decades, colorectal cancer has transitioned from being primarily a disease of the elderly to an increasingly prevalent condition among adults aged 50 and younger, particularly in high-income nations such as the United States. This alarming shift in epidemiology has puzzled medical researchers and public health officials alike, prompting numerous investigations into potential causative factors. Now, a pioneering study led by scientists at Mass General Brigham as part of the Cancer Grand Challenges PROSPECT team sheds light on a compelling and modifiable risk element: consumption of ultra-processed foods.
Ultra-processed foods, characterized by their industrial formulations often rich in sugars, salts, saturated fats, and artificial additives, have surged in popularity in tandem with modern dietary trends. These convenient ready-to-eat or heat products have become staple components of many individuals’ diets, especially in developed countries. The Mass General Brigham-based study analyzed dietary intake and clinical endoscopic screening data from nearly 30,000 women to investigate the potential link between ultra-processed food consumption and the development of colorectal cancer precursors, notably adenomas, which are known precursors to early-onset colorectal cancer (EOCRC).
The researchers drew upon the vast dataset of the Nurses’ Health Study II, an ongoing longitudinal cohort study that follows female nurses born between 1947 and 1964—a generation increasingly recognized as bearing elevated EOCRC risk. Over 24 years of meticulous data collection, which integrated biennial dietary surveys tracking participants’ food intake alongside lower gastrointestinal endoscopies conducted before each participant’s 50th birthday, the study established a robust temporal relationship between ultra-processed food consumption and colorectal carcinogenic precursors.
Quantitatively, the study found that participants consuming the upper echelon of ultra-processed food intake—averaging approximately 10 servings per day—exhibited a startling 45% increase in the risk of developing conventional adenomas compared to those who consumed the least amount, averaging 3 servings per day. Notably, this association did not extend to serrated lesions, a different histological subtype of colorectal precancerous tissue that generally progresses more slowly and is less commonly linked to EOCRC. These findings implicate ultra-processed foods as a significant dietary driver of early colorectal neoplasia.
One of the most rigorous aspects of this study was its comprehensive adjustment for confounding variables known to influence colorectal cancer risk. Researchers systematically accounted for factors including body mass index, presence of type 2 diabetes, dietary fiber consumption, smoking status, physical activity, and alcohol consumption. Even after controlling for these potential confounders, the statistical relationship between high ultra-processed food intake and adenoma risk remained robust and linear, reinforcing the plausibility that dietary quality independently contributes to early colorectal carcinogenesis.
Underlying mechanisms hypothesized by the investigators point to the complex chemical milieu inherent in ultra-processed foods. Many of these items contain additives, preservatives, emulsifiers, and artificial flavorings that may perturb gut microbiota balance, promote chronic inflammation, and induce genotoxicity within the colonic epithelium. Furthermore, the abundance of refined sugars and saturated fats may exacerbate metabolic derangements such as insulin resistance and systemic inflammation, both of which are implicated in tumorigenesis. However, the precise biological pathways warrant further molecular and clinical study to unravel the intricate interplay between diet and colorectal cancer initiation.
Importantly, this study marks the first demonstrable connection between consumption of ultra-processed foods and early-onset colorectal cancer precursors—a cancer subtype whose incidence has been rising alarmingly in recent years. Previous research by the same group and others had linked ultra-processed foods to colorectal cancer overall, but this work zeroes in on the younger demographic, highlighting an urgent public health concern that merits intervention efforts targeting dietary modifications in at-risk populations.
Despite these compelling findings, the authors emphasize that ultra-processed food intake alone does not fully account for the surge in EOCRC incidence. Clinicians at Mass General Brigham observe that many patients diagnosed with early-onset colon cancer often maintain relatively healthy diets, indicating the presence of additional environmental, genetic, or lifestyle risk modifiers yet to be identified. Ongoing research endeavors within the PROSPECT team aim to broaden the scope of investigation to uncover other etiological contributors and improve risk stratification models.
The study also highlights the need for more nuanced categorization of ultra-processed foods. Recognizing that this heterogeneous group spans a wide range of products with varying nutrient profiles and additive compositions, future work intends to determine whether certain subtypes of ultra-processed foods confer greater carcinogenic potential than others. This granular understanding could inform targeted dietary guidelines and regulatory policies to mitigate colorectal cancer risk.
Clinically, these findings reinforce the call for increased public health messaging advocating for reductions in ultra-processed food consumption, particularly for younger adults. Since adenomas are precursors to colorectal carcinomas, lowering their incidence through dietary intervention could translate into concrete decreases in EOCRC rates. Such efforts would require multidisciplinary collaboration among healthcare providers, nutritionists, policy makers, and educators to create sustainable behavior change and food system reform.
In summary, this seminal observational study provides pivotal evidence linking ultra-processed food consumption with precancerous adenomas in a large cohort of women under 50, elucidating an actionable pathway to potentially reverse the troubling rise of early-onset colorectal cancer. As ultra-processed foods remain ubiquitous within modern food environments, understanding their full impact on human health has never been more pressing. The work spearheaded by Mass General Brigham investigators marks a critical advance toward illuminating the diet-cancer nexus and guiding preventive strategies for future generations.
Subject of Research: People
Article Title: Ultra-Processed Food Consumption and Risk of Early-Onset Colorectal Cancer Precursors among Women
News Publication Date: 13-Nov-2025
Web References: http://dx.doi.org/10.1001/jamaoncol.2025.4777
References: Wang, C et al. “Ultra-Processed Food Consumption and Risk of Early-Onset Colorectal Cancer Precursors among Women” JAMA Oncology DOI: 10.1001/jamaoncol.2025.4777
Keywords: Colorectal cancer, Diets, Epidemiology, Public health
