Introduction
Materials and methods
Literature search and selection
Data extraction
Statistical analysis
Results
Literature search
Study characteristics
References | Study name | Country | Study period | No. of cases | Study size | Exposure definition | Exposure contrasts | RR (95% CI) | Adjustment variables |
---|---|---|---|---|---|---|---|---|---|
Cohort
| |||||||||
Jakszyn [39] | European Prospective Investigation into Cancer and Nutrition | Europe | 1001 | 481,419 | Red meat (fresh and processed) | Red meat | Age, gender, center, educational level, BMI (as continuous variable), smoking status, lifetime intensity of smoking (number of cigarettes per day), time since quitting or duration of smoking, and total energy intake | ||
57.86–91.42 g/day versus 0–57.86 g/day | 1.2 (0.96–1.49) | ||||||||
91.42–130.63 g/day versus 0–57.86 g/day | 1.14 (0.91–1.41) | ||||||||
130.63–754.79 g/day versus 0–57.86 g/day | 1.15 (0.9–1.45) | ||||||||
Ferrucci [40] | NIH-AARP Diet and Health Study | USA | 1995–2004 | 854 | 300,933 | Red meat (bacon, beef, cold cuts, ham, hamburger, hot dogs, liver, pork, sausage, and steak) and processed meat (bacon, sausage, luncheon meats, ham, and hot dogs) | Red meat | Age (continuous, years), sex, smoking (never, quit 10 years ago, quit 5–9 years ago, quit 1–4 years ago, quit <1 year ago, or 20 cigarettes/day, 20–40 cigarettes/day, >40 cigarettes/day), and intakes of fruit (continuous, cup equivalents/1000 kcal), vegetables continuous, cup equivalents/1000 kcal), beverages (continuous, mL/day; sum of beer, coffee, juice, liquor, milk, soda, tea and wine), and total energy (continuous, kcal/day) | |
20.9 g per 1000 kcal versus 9.5 g per 1000 kcal | 0.99 (0.78–1.25) | ||||||||
30.7 g per 1000 kcal versus 9.5 g per 1000 kcal | 1.05 (0.83–1.33) | ||||||||
42.1 g per 1000 kcal versus 9.5 g per 1000 kcal | 0.97 (0.77–1.23) | ||||||||
61.6 g per 1000 kcal versus 9.5 g per 1000 kcal | 1.22 (0.96–1.54) | ||||||||
Processed meat | |||||||||
4.3 g per 1000 kcal versus 1.6 g per 1000 kcal | 1.09 (0.85–1.39) | ||||||||
7.4 g per 1000 kcal versus 1.6 g per 1000 kcal | 1.1 (0.86–1.41) | ||||||||
12.1 g per 1000 kcal versus 1.6 g per 1000 kcal | 1.28 (1.01–1.62) | ||||||||
22.3 g per 1000 kcal versus 1.6 g per 1000 kcal | 1.10 (0.86–1.40) | ||||||||
Larrson [41] | Swedish Mammography Cohort and the Cohort of Swedish Men | Sweden | 1998–2007 | 485 | 82,002 | Red meat (meatballs or hamburger, beef, pork, veal, kidney, and liver) and processed meat (sausage, ham, salami, and cold cuts) | Red meat | Age, sex, education, smoking status, pack-years of smoking, and total energy intake | |
1–4 servings/week versus 0–3 servings/month | 1.11 (0.81–1.52) | ||||||||
≥5 servings/week versus 0–3 servings/month | 1.00 (0.71–1.41) | ||||||||
Processed meat | |||||||||
1–4 servings/week versus 0–3 servings/month | 0.87 (0.68–1.11) | ||||||||
≥5 servings/week versus 0–3 servings/month | 1.91 (0.80–1.28) | ||||||||
Michaud [42] | Health Professionals Follow-Up Study and the Nurses’ Health Study | USA | 1986–2002 and 1976–2002 | 808 | 135,893 | Red meat (hamburger, beef, pork, lamb as main or mixed dish) and processed meats (bacon, hot dogs, sausage, salami, bologna) | Hamburger | Age, caloric intake (quintiles), and pack-years of smoking and for geographic region | |
0 serving/month versus 1–3 servings/month | 0.99 (0.72–1.36) | ||||||||
1 serving/week versus 1–3 servings/month | 0.86 (0.68–1.08) | ||||||||
2–4 servings/week versus 1–3 servings/month | 0.91 (0.70–1.17 | ||||||||
Beef, pork, or lamb (main dish) | |||||||||
0 serving/month versus 1–3 servings/month | 1.35 (0.94–1.96) | ||||||||
1 serving/week versus 1–3 servings/month | 1.01 (0.78–1.33) | ||||||||
2–4 servings/week versus 1–3 servings/month | 1.11 (0.85–1.45) | ||||||||
≥5 servings/week versus 1–3 servings/month | 0.93 (0.57–1.52) | ||||||||
Beef, pork, or lamb (sandwich or mixed dish) | |||||||||
0 serving/month versus 1–3 servings/month | 1.06 (0.79–1.43) | ||||||||
1 serving/week versus 1–3 servings/month | 0.83 (0.65–1.06) | ||||||||
2–4 servings/week versus 1–3 servings/month | 1.26 (0.98–1.63) | ||||||||
≥5 servings/week versus 1–3 servings/month | 0.95 (0.51–1.75) | ||||||||
Hamburger: | |||||||||
0 serving/month versus 1–3 servings/month | 1.07 (048–2.41) | ||||||||
1 serving/week versus 1–3 servings/month | 1.13 (0.80–1.60) | ||||||||
2–4 serving/week versus 1–3 servings/month | 0.96 (0.66–1.38) | ||||||||
Beef, pork, or lamb (main dish): | |||||||||
0 serving/month versus 1–3 servings/month | 2.28 (0.88–5.92) | ||||||||
1 serving/week versus 1–3 servings/month | 1.35 (0.76–2.39) | ||||||||
2–4 servings/week versus 1–3 servings/month | 1.23 (0.71–2.11) | ||||||||
≥5 servings/week versus 1–3 servings/month | 1.01 (0.56–1.65) | ||||||||
Beef, pork, or lamb (sandwich or mixed dish) | |||||||||
0 serving/month versus 1–3 servings/month | 1.61 (0.92–2.81) | ||||||||
1 serving/week versus 1–3 servings/month | 1.03 (0.75–1.41) | ||||||||
2–4 servings/week versus 1–3 servings/month | 0.92 (0.66–1.27) | ||||||||
≥5 servings/week versus 1–3 servings/month | 0.83 (0.40–1.71) | ||||||||
Processed meats (e.g., sausage, salami, bologna) | |||||||||
1–3 servings/month versus 0 serving/month | 0.98 (0.76–1.25) | ||||||||
1 serving/week versus 0 serving/month | 0.94 (0.71–1.23) | ||||||||
2–4 servings/week versus 0 serving/month | 0.98 (0.74–1.30) | ||||||||
≥5 servings/week versus 0 serving/month | 1.09 (0.71–1.69) | ||||||||
Bacon | |||||||||
1–3 servings/month versus 0 serving/month | 1.08 (0.86–1.37) | ||||||||
1 serving/week versus 0 serving/month | 1.09 (0.84–1.41) | ||||||||
2–4 servings/week versus 0 serving/month | 1.10 (0.82–1.49) | ||||||||
≥5 servings/week versus 0 serving/month | 1.63 (1.02–2.62) | ||||||||
Hot dog | |||||||||
1–3 servings/month versus 0 serving/month | 1.02 (0.83–1.25) | ||||||||
1 serving/week versus 0 serving/month | 1.02 (0.78–1.34) | ||||||||
2–4 servings/week versus 0 serving/month | 0.86 (0.58–1.27) | ||||||||
Processed meats (e.g., sausage, salami, bologna) | |||||||||
1–3 servings/month versus 0 serving/month | 1.07 (0.76–1.52) | ||||||||
1 serving/week versus 0 serving/month | 1.25 (0.86–1.84) | ||||||||
2–4 servings/week versus 0 serving/month | 0.98 (0.65–1.46) | ||||||||
≥5 servings/week versus 0 serving/month | 0.81 (0.40–1.63) | ||||||||
Bacon | |||||||||
1–3 servings/month versus 0 serving/month | 0.90 (0.65–1.25) | ||||||||
1 serving/week versus 0 serving/month | 1.06 (0.74–1.51) | ||||||||
2–4 servings/week versus 0 serving/month | 1.00 (0.67–1.51) | ||||||||
≥5 servings/week versus 0 serving/month | 1.48 (0.70–3.16) | ||||||||
Hot dog | |||||||||
1–3 servings/month versus 0 serving/month | 0.91 (0.66–1.24) | ||||||||
1 serving/week versus 0 serving/month | 0.89 (0.63–1.27) | ||||||||
2–4 servings/week versus 0 serving/month | 0.77 (0.47–1.24) | ||||||||
Nagano [43] | Life-Span Study | Japan | 1979–1993 | 114 | 38,540 | Red meat and processed meat (ham, sausage) | Red meat | Age, gender, radiation dose, smoking status, education level, body mass index, and calendar time | |
2–4 servings/week versus 0–1 serving/week | 0.68 (0.45–1.04) | ||||||||
5+ servings/week versus 0–1 serving/week | 1.13 (0.53–2.19) | ||||||||
Ham and sausage | |||||||||
1 serving/week versus 0 serving/week | 0.54 (0.31–0.92) | ||||||||
2+ servings/week versus 0 serving/week | 0.73 (0.42–1.28) | ||||||||
Case–control
| |||||||||
Catsburg [44] | USA | 1987–1996 | 1660 | 3246 | Processed meat (fried bacon, ham, salami, pastrami, corned beef, bologna, other lunch meats, hot dogs and polish sausage) | Processed meat | Age, sex, BMI (underweight/normal <25, overweight 25–30, obese >30), race/ethnicity (non-Hispanic white/Hispanic/black or other), education (high school/1- to 4-year college/grad school), history of diabetes (yes/no), total vegetable intake per day, vitamin A intake (IU per day), vitamin C intake (mg per week), carotenoid intake (mcg per day), total servings of food per day, smoking duration (years smoked) and smoking intensity (cigarettes per day) | ||
1–2 times a week versus < Once a week | 0.96 (0.76–1.23) | ||||||||
3 times a week versus < Once a week | 1.11 (0.87–1.41) | ||||||||
4–6 times a week versus < Once a week | 1.23 (0.96–1.58) | ||||||||
>1 time a day versus < Once a week | 0.97 (0.74–1.27) | ||||||||
Isa [45] | China | 2005–2008 | 487 | 956 | Red meat and preserved meat | 2–4 times/week versus ≤1 times/week | 1.20 (0.90–2.10) | Sex, age (categorical), smoking status (categorical), smoking duration (continuous), smoking amount (continuous), and other food groups | |
≥5 times/week versus ≤1 times/week | 1.80 (1.10–3.00) | ||||||||
Preserved meat | |||||||||
<1 times/month versus never | 1.60 (1.00–2.80) | ||||||||
1–3 times/month versus never | 1.70 (0.90–3.10) | ||||||||
1 times/week versus never | 2.20 (1.00, 4.7) | ||||||||
Wu [46] | USA | 2001–2004 and 2002–2004 | 1171 | 2535 | Red meat (beef, veal, pork, and lamb) and processed meat (ham, bacon, sausage, hot dog, cold cuts, turkey sausages and hot dogs, and poultry cold cuts) | Red meat | Gender, age (0–54, 55–64, 65–74, 75+), region, race (White/other), Hispanic status, smoking status (never, occasional, former, current), usual BMI (continuous), and total energy (kcal per day—continuous) | ||
27.6 g per 1000 kcal versus 17.2 per 1000 kcal | 0.97 (0.76–1.24) | ||||||||
37.4 g per 1000 kcal versus 17.2 per 1000 kcal | 1.04 (0.81–1.33) | ||||||||
53 g per 1000 kcal versus 17.2 per 1000 kcal | 1.14 (0.89–1.46) | ||||||||
Processed meat | |||||||||
6.1 g per 1000 kcal versus 2.9 per 1000 kcal | 1.01 (0.78–1.30) | ||||||||
10.1 g per 1000 kcal versus 2.9 per 1000 kcal | 1.19 (0.92–1.53) | ||||||||
18.4 g per 1000 kcal versus 2.9 per 1000 kcal | 1.28 (1.00–1.65) | ||||||||
Lin [8] | USA | 1999 | 884 | 1762 | Red meat (beef, veal, lamb, pork and game) and processed meat (hot dogs or franks, sausage or chorizo) | Red meat | Age, sex, ethnicity, smoking status, pack-year of smoking, energy intake, total vegetable intake, total fruit intake, and BMI | ||
0.55–1.10 once versus <0.55 once | 1.17 (0.87–1.58) | ||||||||
1.11–2.05 once versus <0.55 once | 1.47 (1.09–1.99) | ||||||||
≥2.06 once versus <0.55 once | 1.95 (1.41–2.68) | ||||||||
Processed meat: | |||||||||
0.11–0.28 once versus <0.11 once | 0.88 (0.66–1.18) | ||||||||
0.29–0.61 once versus <0.11 once | 0.98 (0.73–1.31) | ||||||||
≥0.62 once versus <0.11 once | 1.03 (0.76–1.39) | ||||||||
Aune [7] | Uruguay | 1996–2004 | 255 | 2287 | Red meat (fresh meat including beef and lamb) and processed meat (hot dogs, sausages, ham, salami, saucisson, mortadella, bacon and salted meat) | 10–40 g/day versus 0–10 g/day | 1.01 (0.70–1.46) | Age, sex, residence, education, income, interviewer, smoking status, cigarettes per day, duration of smoking, age at starting, years since quitting, alcohol, dairy foods, grains, fatty foods (butter, eggs, custard, cake), fruits and vegetables, fish, poultry, mate drinking, BMI, and energy intake | |
>40–258.8 versus 0–10 g/day | 1.43 (0.93–2.20) | ||||||||
Hu [47] | Canada | 1994–1997 | 1209 | 6248 | Red meat (beef, pork, lamb as a main or mixed dish and hamburger) and processed meat (hot dogs, smoked meat, corned beef, bacon and sausage) | Red meat | Age group (20–49, 50–59, 60–69, 70–76), province, education, body mass index (<25, 25–29.9, ≥30), sex, alcohol use (g/day), pack-year smoking, total of vegetable and fruit intake, and total energy intake | ||
2.1–3.94 times/week versus ≤2 times/week | 1.20 (1.00–1.60) | ||||||||
3.95–5 times/week versus ≤2 times/week | 1.20 (090–1.50) | ||||||||
≥5.42 times/week versus ≤2 times/week | 1.30 (1.0–1.70) | ||||||||
Processed meat: | |||||||||
0.95–2.41 times/week versus ≤0.94 times/week | 1.20 (1.10–1.60) | ||||||||
2.42–5.41 times/week versus ≤0.94 times/week | 1.50 (1.10–1.90) | ||||||||
≥5.42 times/week versus ≤0.94 times/week | 1.60 (1.20–2.10) | ||||||||
Closas [48] | Spain | 1998–2001 | 912 | 1785 | Red meat (beef, veal, lamb, pork) and processed meat | Red meat: | Age (<55, 55–64, 65–69, 70–74, >74 years old), gender, region, smoking status (never, occasional, former, current), duration of smoking (<20, 20–<30, 30–<40, 40–<50, ≥ 50 years) and quintiles of fruit and vegetable intake | ||
(20–32) g per 1000 kcal versus <20 g per kcal | 1.10 (0.80–1.50) | ||||||||
(33–43) g per 1000 kcal versus <20 g per kcal | 1.10 (0.80–1.50) | ||||||||
(44–58) g per 1000 kcal versus <20 g per kcal | 1.00 (0.70–1.30) | ||||||||
(>58) g per 1000 kcal versus <20 g per kcal | 0.80 (0.60–1.10) | ||||||||
Processed meat: | |||||||||
(4–9) g per 1000 kcal versus <4 g per kcal | 1.40 (1.00–1.90) | ||||||||
(10–12) g per 1000 kcal versus <4 g per kcal | 1.20 (0.90–1.70) | ||||||||
(13–18) g per 1000 kcal versus <4 g per kcal | 1.20 (0.80–1.60) | ||||||||
(>18) g per 1000 kcal versus <4 g per kcal | 1.20 (0.90–1.70) | ||||||||
Tavani [49] | Italy | 1983–1996 | 431 | 8421 | Red meat (beef, veal and pork) | Red meat | Age, year of recruitment, sex, education, smoking habits and alcohol, fat, fruit and vegetable intakes | ||
3–6 times/week versus ≤3/week | 1.40 (1.20–1.80) | ||||||||
≥6 times/week versus ≤3 times/week | 1.60 (1.20–2.10) |