Kentucky has the highest incidence and mortality rate of all site cancers, and Kentuckians residing in the Appalachian region often have worse outcomes, where cancer is a leading cause of death. Focusing on colorectal cancer (CRC) specifically, Kentucky ranks first nationwide for incidence (50 cases per 100,000 people) and fifth for mortality (about 17 deaths per 100,000 people). The Kentucky Colon Cancer Screening Program increased screening rates and reduced mortality since its launch. Yet, CRC remains a leading cause of death for Kentuckians. Risk factors for CRC include increasing age as well as a history of inflammatory bowel disease (IBD) and genetics. But what about nutrition? This article will discuss the role of specific nutrients as they relate to CRC risk and development.