Purpose To update evidence for the correlation between yogurt consumption and risk of colorectal cancer (CRC), particularly by CRC anatomical site including proximal and distal colon, as well as the rectum. We also examined whether the association between yogurt intake and CRC persists after controlling for calcium, a known protective dietary element for CRC.

Methods We conducted an updated meta-analysis for the studies investigating the association between yogurt consumption and CRC published in PubMed, Embase, and Web of Science. Effect estimates were pooled and reported as odds ratio (OR) with 95% confidence intervals (CI) for CRC risk. Subgroup analysis for CRC risk per anatomical site was conducted. Additionally, pooled OR for calcium-controlled studies was evaluated.

Results Thirteen studies (seven cohorts and six case-control studies), comprising a sample size of 1,312,607, were included. Our results showed that yogurt consumption was associated with a lower CRC risk (OR = 0.89, 95% CI: 0.84-0.95). Per anatomical site, proximal colon cancer demonstrated the lowest risk (OR = 0.86, 95% CI: 0.75-0.98), followed by distal colon cancer (OR = 0.90, 95% CI: 0.84-0.97) and rectal cancer (OR = 0.92, 95% CI: 0.86-0.98). When adjusting for calcium intake, yogurt consumption maintained a significant but weaker association with CRC risk (OR = 0.95, 95% CI: 0.91-0.99).

Conclusion Yogurt consumption was associated with a lower risk for CRC incidence that differed slightly by anatomical site of the colon. The observed protection, particularly in the proximal colon, suggests that yogurt may influence CRC risk via microbiome-mediated pathways, such as increased short-chain fatty acid production by live cultures contained in yogurt, including Streptococcus thermophilus and Lactobacillus strains. The evidence that yogurt has independent effects after controlling for calcium and for the proximal colon requires further exploration.