Jordi de Batlle1, Esther Gracia-Lavedan2,3,4, Dora Romaguera5,6,7, Michelle Mendez8,9, Gemma Castaño-Vinyals2,3,4,10, Vicente Martín3,11, Núria Aragonés3,12,13,14, Inés Gómez-Acebo3,15, Rocío Olmedo-Requena3,16,17, José Juan Jimenez-Moleon3,16,17, Marcela Guevara3,18, Mikel Azpiri19, Cristóbal Llorens-Ivorra20, Guillermo Fernandez-Tardon3,21, Jose Andrés Lorca22, José María Huerta23, Victor Moreno3,24,25, Elena Boldo3,12,13,14, Beatriz Pérez-Gómez3,12,13,14, Jesús Castilla3,18, Tania Fernández-Villa11, Juan Pablo Barrio11, Montserrat Andreu26, Antoni Castells27, Trinidad Dierssen3,15, Jone M Altzibar3,19, Manolis Kogevinas2,3,4,10, Marina Pollán3,12,13,14, Pilar Amiano3,19. 1. International Agency for Research on Cancer (IARC), Lyon, France. 2. ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. 3. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. 4. Universitat Pompeu Fabra (UPF), Barcelona, Spain. 5. ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. mariaadoracion.romaguera@ssib.es. 6. Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Unidad de Investigación, I-1. Carretera de Valldemossa, 79, 07120, Palma de Mallorca, Spain. mariaadoracion.romaguera@ssib.es. 7. CIBER Fisiopatología de la Obesidad y la Nutrición (CIBER-OBN), Madrid, Spain. mariaadoracion.romaguera@ssib.es. 8. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA. 9. Carolina Population Center and Lineberger Cancer Center, University of North Carolina, Chapel Hill, NC, USA. 10. IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. 11. Grupo de Investigación en Interacciones gen-ambiente y salud, Universidad de León, León, Spain. 12. Instituto de Salud Carlos III, Madrid, Spain. 13. Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain. 14. Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Majadahonda, Madrid, Spain. 15. Universidad de Cantabria - IDIVAL, Santander, Spain. 16. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain. 17. Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Complejo Hospitales Universitarios de Granada, Universidad de Granada, Granada, Spain. 18. Instituto de Salud Pública de Navarra, IdiSNA, Pamplona, Spain. 19. Public Health Division of Gipuzkoa, BioDonostia Research Institute, Government of the Basque Country, San Sebastian, Spain. 20. Centro de Salud Pública de Dénia, Consellería de Sanidad Universal y Salud Pública, Generalitat Valenciana, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), València, Spain. 21. IUOPA, Preventive Medicine Department, University of Oviedo, Oviedo, Spain. 22. Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain. 23. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. 24. IDIBELL-Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain. 25. Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain. 26. Department of Gastroenterology, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Pompeu Fabra University, Barcelona, Spain. 27. Gastroenterology Department, Hospital Clínic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Catalonia, Spain.
Abstract
PURPOSE: Although there is convincing evidence that red and processed meat intake increases the risk of colorectal cancer (CRC), the potential role of meat cooking practices has not been established yet and could partly explain the current heterogeneity of results among studies. Therefore, we aimed to investigate the association between meat consumption and cooking practices and the risk of CRC in a population-based case-control study. METHODS: A total of 1671 CRC cases and 3095 controls recruited in Spain between September 2008 and December 2013 completing a food frequency questionnaire with a meat-specific module were included in the analyses. Odds ratios (OR) and confidence intervals (CI) were estimated by logistic regression models adjusted for known confounders. RESULTS: Total meat intake was associated with increased risk of CRC (OR T3-T1 1.41; 95% CI 1.19-1.67; p trend < 0.001), and similar associations were found for white, red and processed/cured/organ meat. Rare-cooked meat preference was associated with low risk of CRC in red meat (ORrare vs. medium 0.66; 95% CI 0.51-0.85) and total meat (ORrare vs. medium 0.56; 95% CI 0.37-0.86) consumers, these associations being stronger in women than in men. Griddle-grilled/barbecued meat was associated with an increased CRC risk (total meat: OR 1.45; 95% CI 1.13-1.87). Stewing (OR 1.25; 95% CI 1.04-1.51) and oven-baking (OR 1.18; 95% CI 1.00-1.40) were associated with increased CRC risk of white, but not red, meat. CONCLUSIONS: Our study supports an association of white, red, processed/cured/organ and total meat intake with an increased risk of CRC. Moreover, our study showed that cooking practices can modulate such risk.
PURPOSE: Although there is convincing evidence that red and processed meat intake increases the risk of colorectal cancer (CRC), the potential role of meat cooking practices has not been established yet and could partly explain the current heterogeneity of results among studies. Therefore, we aimed to investigate the association between meat consumption and cooking practices and the risk of CRC in a population-based case-control study. METHODS: A total of 1671 CRC cases and 3095 controls recruited in Spain between September 2008 and December 2013 completing a food frequency questionnaire with a meat-specific module were included in the analyses. Odds ratios (OR) and confidence intervals (CI) were estimated by logistic regression models adjusted for known confounders. RESULTS: Total meat intake was associated with increased risk of CRC (OR T3-T1 1.41; 95% CI 1.19-1.67; p trend < 0.001), and similar associations were found for white, red and processed/cured/organ meat. Rare-cooked meat preference was associated with low risk of CRC in red meat (ORrare vs. medium 0.66; 95% CI 0.51-0.85) and total meat (ORrare vs. medium 0.56; 95% CI 0.37-0.86) consumers, these associations being stronger in women than in men. Griddle-grilled/barbecued meat was associated with an increased CRC risk (total meat: OR 1.45; 95% CI 1.13-1.87). Stewing (OR 1.25; 95% CI 1.04-1.51) and oven-baking (OR 1.18; 95% CI 1.00-1.40) were associated with increased CRC risk of white, but not red, meat. CONCLUSIONS: Our study supports an association of white, red, processed/cured/organ and total meat intake with an increased risk of CRC. Moreover, our study showed that cooking practices can modulate such risk.
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