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Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition.

Teresa Norat 1 Sheila Bingham 2 Pietro Ferrari 1 Nadia Slimani 1 Mazda Jenab 1 Mathieu Mazuir 1 Kim Overvad 3, 4 Anja Olsen 5 Anne Tjønneland 5 Françoise Clavel 6 Marie-Christine Boutron-Ruault 6 Emmanuelle Kesse 6 Heiner Boeing 7 Manuela Bergmann 7 Alexandra Nieters 8 Jakob Linseisen 8 Antonia Trichopoulou 9 Dimitrios Trichopoulos 9 Yannis Tountas 9 Franco Berrino 10 Domenico Palli 11 Salvatore Panico 12 Rosario Tumino 13 Paolo Vineis 14 H Bas Bueno-De-Mesquita 15 Petra Peeters 16 Dagrun Engeset 17 Eiliv Lund 17 Guri Skeie 17 Eva Ardanaz 18 Carlos González 19 Carmen Navarro 20 J Ramón Quirós 21 María-José Sanchez 22 Göran Berglund 23 Irene Mattisson 23 Göran Hallmans 24 Richard Palmqvist 25 Nicholas Day 26 Kay-Tee Khaw 27 Timothy Key 28 Miguel San Joaquin 28 Bertrand Hémon 1 Rodolfo Saracci 1 Rudolf Kaaks 1 Elio Riboli 1, *
Abstract : BACKGROUND: Current evidence suggests that high red meat intake is associated with increased colorectal cancer risk. High fish intake may be associated with a decreased risk, but the existing evidence is less convincing. METHODS: We prospectively followed 478 040 men and women from 10 European countries who were free of cancer at enrollment between 1992 and 1998. Information on diet and lifestyle was collected at baseline. After a mean follow-up of 4.8 years, 1329 incident colorectal cancers were documented. We examined the relationship between intakes of red and processed meat, poultry, and fish and colorectal cancer risk using a proportional hazards model adjusted for age, sex, energy (nonfat and fat sources), height, weight, work-related physical activity, smoking status, dietary fiber and folate, and alcohol consumption, stratified by center. A calibration substudy based on 36 994 subjects was used to correct hazard ratios (HRs) and 95% confidence intervals (CIs) for diet measurement errors. All statistical tests were two-sided. RESULTS: Colorectal cancer risk was positively associated with intake of red and processed meat (highest [>160 g/day] versus lowest [<20 g/day] intake, HR = 1.35, 95% CI = 0.96 to 1.88; Ptrend = .03) and inversely associated with intake of fish (>80 g/day versus <10 g/day, HR = 0.69, 95 % CI = 0.54 to 0.88; Ptrend<.001), but was not related to poultry intake. Correcting for measurement error strengthened the associations between colorectal cancer and red and processed meat intake (per 100-g increase HR = 1.25, 95% CI =1.09 to 1.41, Ptrend = .001 and HR = 1.55, 95% CI = 1.19 to 2.02, Ptrend = .001 before and after calibration, respectively) and for fish (per 100 g increase HR = 0.70, 95% CI = 0.57 to 0.87, Ptrend<.001 and HR = 0.46, 95% CI = 0.27 to 0.77, Ptrend = .003; before and after correction, respectively). In this study population, the absolute risk of development of colorectal cancer within 10 years for a study subject aged 50 years was 1.71% for the highest category of red and processed meat intake and 1.28% for the lowest category of intake and was 1.86% for subjects in the lowest category of fish intake and 1.28% for subjects in the highest category of fish intake. CONCLUSIONS: Our data confirm that colorectal cancer risk is positively associated with high consumption of red and processed meat and support an inverse association with fish intake.
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Teresa Norat, Sheila Bingham, Pietro Ferrari, Nadia Slimani, Mazda Jenab, et al.. Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition.. J Natl Cancer Inst, 2005, 97 (12), pp.906-16. ⟨10.1093/jnci/dji164⟩. ⟨inserm-00123284⟩

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