Colorectal
Signal score, how each part rates
ActionabilityPrevalenceStakesEvidence strengthNovelty
See the full rubric →One-carbon metabolism and chemotherapy-induced toxicities in patients with stage II-III colorectal cancer: a prospective cohort study.
Clinical takeawayNo clinical action yet: associations in a prospective cohort require validation in interventional trials before modifying nutrition or supplementation.
What it foundHigher folate (HR 0.75, 95% CI 0.57-0.98) and vitamin B2 (HR 0.81, 95% CI 0.67-0.99) were associated with lower capecitabine toxicity risk specifically in patients with MTHFR C677T CT/TT genotype, while higher glycine (HR 1.87, 95% CI 1.18-2.94) increased toxicity risk. Nonlinear associations were observed for vitamin B6 and vitamin B12.
ContextSuggests potential for personalized nutrition strategies to mitigate capecitabine toxicity in patients with MTHFR C677T CT/TT genotype, but current practice does not routinely adjust OCM biomarkers pre-chemotherapy.
Emergingsuggested applicable standard· U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017
Decision at stakeoptimizing chemotherapy tolerance in stage II-III colorectal cancer patients
U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017 · reviewed 2026-07-23 ↗Begin average-risk colorectal cancer screening at age 45 using a patient-centered shared-decision modality choice, colonoscopy every 10 years (preferred) or annual FIT as Tier 1 options, with multi-target stool DNA every 3 years, CT colonography every 5 years, or flexible sigmoidoscopy every 5 to 10 years as Tier 2 alternatives. A positive stool-based test requires diagnostic colonoscopy, and stool tests should not be ordered for patients who would decline follow-up colonoscopy. Generally stop at age 75 with individualized decisions for ages 76-85 and no screening beyond 85.
Zwart NRK … Kok DE · American Journal of Clinical Nutrition · IF 6.5 · PubMed ↗