Meat consumption and risk of stomach cancer in Uruguay: a case-control study.

We previously reported an association between meat intake and stomach cancer in Uruguay: in that analysis, we did not control for total energy intake. To better study the relationship between intake of meat and meat constituents and gastric cancer, we conducted a further case-control study including 123 cases and 282 controls who were enrolled between September 1997 and August 1999. Total meat intake (highest tertile) was associated with an odds ratio (OR) of 4.6 [95% confidence interval (CI) = 2.3-9.0]. After adjustment for total energy intake and intake of proteins and total fat by the residuals method, the OR was 1.7 (95% CI = 0.7-4.0). The energy-adjusted OR for high intake of processed meat was 1.9 (95% CI = 1.1-3.5). Intake of fried, barbecued, and salted meat and 2-amino-1-methyl-6-phenyl-imidazo[4,5-b]pyridine was not associated with risk of gastric cancer. The energy-adjusted OR of high intake of nitrosodimethylamine was 1.5 (95% CI = 0.9-2.8). These results suggest that, in a country with elevated meat consumption, total energy intake and intake of proteins and fat are powerful confounders in the relationship between meat intake and gastric cancer risk. However, a modest independent effect of meat, in particular of processed meat, is suggested.