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Association Between Intake of Red and Processed Meat and Survival in Patients With Colorectal Cancer in a Pooled Analysis.
Clin Gastroenterol Hepatol. 2019 07; 17(8):1561-1570.e3.CG

Abstract

BACKGROUND & AIMS

Red and processed meat intake is associated with colorectal cancer (CRC) incidence, but it is not clear if intake is associated with patient survival after diagnosis.

METHODS

We pooled data from 7627 patients with stage I-IV CRC from 10 studies in the International Survival Analysis in Colorectal Cancer Consortium. Cox proportional hazards regression models were used to evaluate the associations of intake of red and processed meat before diagnosis with overall and CRC-specific survival.

RESULTS

Among 7627 patients with CRC, 2338 died, including 1576 from CRC, over a median follow-up time of 5.1 years. In multivariable-adjusted analyses, higher intake of red or processed meat was not associated with overall survival of patients with stage I-III CRC: Q4 vs Q1 red meat hazard ratio [HR], 1.08 (95% CI, 0.93-1.26) and Q4 vs Q1 processed meat HR, 1.10 (95% CI, 0.93-1.32) or with CRC-specific survival: Q4 vs Q1 red meat HR, 1.09 (95% CI, 0.89-1.33) and Q4 vs Q1 processed meat HR, 1.11 (95% CI, 0.87-1.42). Results were similar for patients with stage IV CRC. However, patients with stage I-III CRC who reported an intake of processed meat above the study-specific medians had a higher risk of death from any cause (HR, 1.12; 95% CI, 1.01-1.25) than patients who reported eating at or less than the median.

CONCLUSION

In this large consortium of CRC patient cohorts, intake of red and processed meat before a diagnosis of CRC was not associated with shorter survival time after diagnosis, although a possible weak adverse association cannot be excluded. Studies that evaluate dietary data from several time points before and after cancer diagnosis are required to confirm these findings.

Authors+Show Affiliations

Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany; Genetic Tumour Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg, Hamburg, Germany.Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, New York.Department of Medicine, Georgetown University, Washington, DC.Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts; Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, Massachusetts.Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington.Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah.Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California.Department of Epidemiology, University of Iowa, Iowa City, Iowa.Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington.Department of Nutrition, Harvard T.H Chan School of Public Health, Boston, Massachusetts.Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington.Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington.Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany; German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany.Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. Electronic address: m.hoffmeister@dkfz.de.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

30476588

Citation

Carr, Prudence R., et al. "Association Between Intake of Red and Processed Meat and Survival in Patients With Colorectal Cancer in a Pooled Analysis." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 17, no. 8, 2019, pp. 1561-1570.e3.
Carr PR, Banbury BL, Berndt SI, et al. Association Between Intake of Red and Processed Meat and Survival in Patients With Colorectal Cancer in a Pooled Analysis. Clin Gastroenterol Hepatol. 2019;17(8):1561-1570.e3.
Carr, P. R., Banbury, B. L., Berndt, S. I., Campbell, P. T., Chang-Claude, J., Hayes, R. B., Howard, B. V., Jansen, L., Jacobs, E. J., Lane, D. S., Nishihara, R., Ogino, S., Phipps, A. I., Slattery, M. L., Stefanick, M. L., Wallace, R., Walter, V., White, E., Wu, K., ... Hoffmeister, M. (2019). Association Between Intake of Red and Processed Meat and Survival in Patients With Colorectal Cancer in a Pooled Analysis. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 17(8), 1561-e3. https://doi.org/10.1016/j.cgh.2018.11.036
Carr PR, et al. Association Between Intake of Red and Processed Meat and Survival in Patients With Colorectal Cancer in a Pooled Analysis. Clin Gastroenterol Hepatol. 2019;17(8):1561-1570.e3. PubMed PMID: 30476588.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association Between Intake of Red and Processed Meat and Survival in Patients With Colorectal Cancer in a Pooled Analysis. AU - Carr,Prudence R, AU - Banbury,Barbara L, AU - Berndt,Sonja I, AU - Campbell,Peter T, AU - Chang-Claude,Jenny, AU - Hayes,Richard B, AU - Howard,Barbara V, AU - Jansen,Lina, AU - Jacobs,Eric J, AU - Lane,Dorothy S, AU - Nishihara,Reiko, AU - Ogino,Shuji, AU - Phipps,Amanda I, AU - Slattery,Martha L, AU - Stefanick,Marcia L, AU - Wallace,Robert, AU - Walter,Viola, AU - White,Emily, AU - Wu,Kana, AU - Peters,Ulrike, AU - Chan,Andrew T, AU - Newcomb,Polly A, AU - Brenner,Hermann, AU - Hoffmeister,Michael, Y1 - 2018/11/23/ PY - 2018/08/21/received PY - 2018/11/14/revised PY - 2018/11/16/accepted PY - 2018/11/27/pubmed PY - 2020/10/22/medline PY - 2018/11/27/entrez KW - Colon Cancer KW - Epidemiology KW - ISACC KW - Risk Factor SP - 1561 EP - 1570.e3 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin Gastroenterol Hepatol VL - 17 IS - 8 N2 - BACKGROUND & AIMS: Red and processed meat intake is associated with colorectal cancer (CRC) incidence, but it is not clear if intake is associated with patient survival after diagnosis. METHODS: We pooled data from 7627 patients with stage I-IV CRC from 10 studies in the International Survival Analysis in Colorectal Cancer Consortium. Cox proportional hazards regression models were used to evaluate the associations of intake of red and processed meat before diagnosis with overall and CRC-specific survival. RESULTS: Among 7627 patients with CRC, 2338 died, including 1576 from CRC, over a median follow-up time of 5.1 years. In multivariable-adjusted analyses, higher intake of red or processed meat was not associated with overall survival of patients with stage I-III CRC: Q4 vs Q1 red meat hazard ratio [HR], 1.08 (95% CI, 0.93-1.26) and Q4 vs Q1 processed meat HR, 1.10 (95% CI, 0.93-1.32) or with CRC-specific survival: Q4 vs Q1 red meat HR, 1.09 (95% CI, 0.89-1.33) and Q4 vs Q1 processed meat HR, 1.11 (95% CI, 0.87-1.42). Results were similar for patients with stage IV CRC. However, patients with stage I-III CRC who reported an intake of processed meat above the study-specific medians had a higher risk of death from any cause (HR, 1.12; 95% CI, 1.01-1.25) than patients who reported eating at or less than the median. CONCLUSION: In this large consortium of CRC patient cohorts, intake of red and processed meat before a diagnosis of CRC was not associated with shorter survival time after diagnosis, although a possible weak adverse association cannot be excluded. Studies that evaluate dietary data from several time points before and after cancer diagnosis are required to confirm these findings. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/30476588/Association_Between_Intake_of_Red_and_Processed_Meat_and_Survival_in_Patients_With_Colorectal_Cancer_in_a_Pooled_Analysis_ DB - PRIME DP - Unbound Medicine ER -