Unraveling Colorectal Cancer Risks in Golestan
What we eat doesn't just taste good—it may determine our health destiny.
When you think of factors affecting cancer risk, diet might not be the first thing that comes to mind. Yet in Iran's Golestan province, where colorectal cancer rates have been steadily increasing, researchers discovered that what's on the plate could be as important as genes in determining cancer risk.
A groundbreaking case-control study conducted in this northern Iranian region revealed striking connections between specific eating habits and colorectal cancer development, providing valuable insights for prevention strategies in populations facing similar nutritional transitions.
Colorectal cancer represents a significant global health challenge, ranking as the third most common cancer worldwide3 . While genetic factors play a role, environmental influences—particularly diet—have emerged as major contributors to disease development.
Higher risk of death for stage III colon cancer patients with pro-inflammatory diets compared to those with anti-inflammatory diets
Colorectal cancer ranks as the third most common cancer worldwide3
Research presented at the 2025 American Society of Clinical Oncology meeting revealed that patients with stage III colon cancer who consumed pro-inflammatory diets had an 87% higher risk of death than those eating anti-inflammatory diets. This powerful connection between diet and cancer outcomes underscores the critical importance of understanding what we eat.
To investigate dietary risk factors specific to the Iranian population, researchers conducted a hospital-based case-control study published in 20091 . The study compared 47 colorectal cancer patients with 47 healthy controls, examining their nutritional characteristics through detailed questionnaires.
The research team employed a case-control design, recruiting participants diagnosed with colorectal cancer between 2004-2005. Each cancer patient was matched with a healthy control of similar age and gender. The researchers used food frequency questionnaires to assess participants' typical eating patterns, then applied statistical analyses to identify significant differences between the two groups.
This methodological approach allowed scientists to retrospectively examine dietary habits before cancer development, providing crucial insights into potential risk factors. The team paid particular attention to total energy intake, cooking methods, and specific food categories that previous research had linked to colorectal cancer risk.
The study revealed several significant connections between dietary factors and colorectal cancer risk in this population:
Participants consuming more than 1,837.5 Kcal per day faced 3.8 times higher risk of developing colorectal cancer1
Individuals with daily fat intake exceeding 118.5 grams had a 6.5 times higher risk of colorectal cancer1
Using frying as a primary cooking method was associated with a 3-fold increase in cancer risk1
Interesting Finding: The study found no significant protective effect from vegetable consumption, contrary to some previous research—highlighting the potential complexity of diet-cancer relationships across different populations1 .
The Golestan findings align with broader international research on dietary patterns and colorectal cancer risk. A 2025 systematic review of studies worldwide concluded that certain eating patterns significantly impact cancer susceptibility5 .
A 2025 multicenter case-control study in Iran with 865 CRC cases and 3,204 controls found that a Western-type diet—characterized by high consumption of red meat, processed meats, sugary drinks, refined grains, and unhealthy fats—increased colorectal cancer risk by more than 4 times4 .
Conversely, research has identified several dietary approaches that may lower colorectal cancer risk:
Emphasizing fruits, vegetables, whole grains, olive oil, and moderate fish consumption has demonstrated protective effects3
Originally designed for blood pressure control, this pattern rich in plant foods also associates with reduced colorectal cancer risk3
Patterns that reduce body inflammation—rich in leafy greens, colorful vegetables, whole grains, and healthy fats—may improve survival for those already diagnosed2
Based on the accumulating evidence, both for the general population and colorectal cancer survivors, several practical dietary approaches emerge:
A 2025 study of 542,778 women found calcium intake had one of the strongest inverse associations with colorectal cancer risk7
These support healthy digestion and may reduce carcinogen exposure in the colon7
Despite the Golestan findings, most research supports their protective benefits through antioxidants and anti-inflammatory compounds2
These beverages contain beneficial compounds that may lower cancer risk6
Research presented at ASCO 2025 highlighted that combining anti-inflammatory diets with regular exercise created powerful protection for colon cancer survivors2 . Patients who both ate well and exercised regularly (9+ MET hours per week) had a 63% lower risk of death compared to those with poor diets and minimal exercise.
Lower risk of death for patients with healthy diet and regular exercise
MET hours per week of exercise for optimal protection
Protection when combining diet and exercise vs. either alone2
| Research Method | Purpose | Application in CRC Studies |
|---|---|---|
| Food Frequency Questionnaire (FFQ) | Assess habitual dietary intake | Identifies patterns in case-control studies |
| Principal Component Factor Analysis | Derives dietary patterns from data | Identified "Western-type" diet in Iranian study |
| Reduced Rank Regression (RRR) | Creates patterns based on intermediate responses | Identified diet high in unhealthy fats |
| Empirical Dietary Inflammatory Pattern (EDIP) | Scores diet based on inflammatory potential | Linked pro-inflammatory diets to worse survival |
The journey from dinner plate to disease risk is complex, but evidence from Golestan and beyond confirms that our dietary choices significantly impact colorectal cancer susceptibility. While the 2009 Golestan study highlighted the dangers of high-energy, high-fat diets and frying methods, subsequent research has refined our understanding of both risky and protective eating patterns.
Adopting eating patterns rich in plant foods, healthy fats, and adequate calcium while limiting red and processed meats, unhealthy fats, and fried foods represents our most practical strategy for bending the curve of colorectal cancer risk—in Iran and worldwide.