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      Association between ultra-processed food consumption and risk of breast cancer: a systematic review and dose-response meta-analysis of observational studies

      systematic-review

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          Abstract

          Background

          Some epidemiological studies have examined the association between consumption of ultra-processed food (UPF) and the risk of breast cancer. However, the results were inconsistent. Therefore, we carried out a systematic review and dose-response meta-analysis to examine whether an association exists between high consumption of UPF and breast cancer risk.

          Methods

          PubMed/MEDLINE, ISI Web of Science, EBSCO and CNKI databases were systematically searched from inception to May 2023. The summary relative risks (RRs) and 95% confidence intervals (CIs) associated with UPF consumption and breast cancer were calculated using a random-effects model (DerSimonian-Laird method). Heterogeneity between included studies was examined using the Cochran’s Q test and I-square ( I 2) statistics. Publication bias was studied by visual inspection of funnel plot asymmetry and Begg’s and Egger’s tests.

          Results

          Overall, six articles involving 462,292 participants, were eligible to be included in this study. Compared to the lowest consumption, highest consumption of UPF was related to a higher risk of breast cancer (RR = 1.10; 95%CI: 1.00–1.22, p = 0.056). Besides, the linear dose–response analysis showed that each 10% increment in UPF consumption was related to a 5% higher risk of breast cancer (RR = 1.05; 95%CI: 1.00–1.10, p = 0.048). Subgroup analyses suggested that UPF consumption was positively associated with breast cancer risk in case-control studies (RR = 1.13; 95%CI: 1.01–1.26, p = 0.028). Additionally, there was also a significant positive association between UPF consumption and breast cancer risk in the subgroup with sample size<5,000(RR = 1.17; 95%CI: 1.02–1.35, p = 0.028).

          Conclusion

          Our results indicate that higher consumption of UPF is slightly related to a higher risk of breast cancer. Further studies in particular of large prospective cohort studies are warranted to confirm these results.

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          Most cited references55

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Meta-analysis in clinical trials

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              Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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                Author and article information

                Contributors
                Journal
                Front Nutr
                Front Nutr
                Front. Nutr.
                Frontiers in Nutrition
                Frontiers Media S.A.
                2296-861X
                04 September 2023
                2023
                : 10
                : 1250361
                Affiliations
                [1] 1Department of Nutrition, Zhejiang Hospital , Hangzhou, China
                [2] 2Department of Digestion, Zhejiang Hospital , Hangzhou, China
                [3] 3Department of Geriatrics, Zhejiang Hospital , Hangzhou, China
                [4] 4Zhejiang Provincial Key Lab of Geriatrics, Geriatrics Institute of Zhejiang Province , Hangzhou, China
                Author notes

                Edited by: Costanza Maria Cristiani, University of Magna Graecia, Italy

                Reviewed by: Douglas Weed, DLW Consulting Services LLC, United States; Sara Castro, University of Barcelona, Spain

                *Correspondence: Caijuan Si, sicaijuan0926@ 123456126.com
                Article
                10.3389/fnut.2023.1250361
                10507475
                37731393
                9fda4053-096c-417a-9aac-e115dec4884e
                Copyright © 2023 Shu, Zhang, Zhu, Lv and Si.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 05 July 2023
                : 21 August 2023
                Page count
                Figures: 7, Tables: 4, Equations: 0, References: 56, Pages: 13, Words: 8946
                Categories
                Nutrition
                Systematic Review
                Custom metadata
                Nutritional Epidemiology

                ultra-processed food,nova,breast cancer,meta-analysis,systematic review

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