The healthy eating index 2020 and colorectal cancer risk: a prospective study based on the PLCO cohort.

In the fully adjusted Fine–Gray model, participants in the highest HEI-2020 quartile had a lower subdistribution hazard of CRC-specific death than those in the lowest quartile (SHR = 0.64; 95% CI: 0.46–0.88; p = 0.007), with a significant trend across quartiles (P for trend = 0.004; as detailed in Supplementary Table 2 ).

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Site-specific analyses suggested lower risks for distal colon cancer and a borderline lower point estimate for rectal cancer, as well as a decreasing trend in proximal colon cancer mortality.

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The fully adjusted model showed that participants in the highest HEI-2020 quartile had a lower point estimate for CRC incidence than those in the lowest quartile, although this comparison did not reach statistical significance (HR = 0.86; 95% CI: 0.73–1.02).

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