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Table 1 Summary of cohort studies of red meat or processed meat and prostate cancer

From: A review and meta-analysis of prospective studies of red and processed meat intake and prostate cancer

Author and Year

Cohort

Exposure Variable (Definition)

Number of Exposed Cases

Analytical Comparison

Relative Risk Estimatea(95% CI)

Statistical Adjustment

Allen et al. 2008

European Prospective Investigation into Cancer and Nutrition (EPIC)

Red meat

371

5th quintile vs. 1 (median intake = 90 g/day)

0.96 (0.82-1.12)

Stratified by center and adjusted for education, marital status, height, weight and energy intake

  

Processed meat

590

5th quintile vs. 1 (median intake = 88 g/day)

0.93 (0.79-1.09)

 

Allen et al. 2004

Hiroshima and Nagasaki, Japan

Pork

8

Almost daily vs. <2 times/wk

1.24 (0.61-2.54)

Age, calendar period, city of residence, radiation dose, and education level

Chan et al. 2000

ATBC Study (Finland)

Red meat

NR

Quintiles of intake: 5 vs. 1

0.7 (0.5-1.1)

Supplementation, education, and quintiles of age, BMI, energy and smoking

Cross et al. 2007

NIH-AARP Diet & Health Study

Red meat (all types of beef, pork, and lamb; including bacon, beef, cold cuts, ham, hamburger, hot dogs, liver, pork, sausage, and steak; meats added to mixtures, such as pizza, chili, lasagna, and stew)

 

Quintiles of intake: 5 vs. 1 62.7 g/1000 kcal vs. 9.8

 

Age, sex, education, marital status, family hx of cancer, race, BMI, smoking, frequency of vigorous physical activity, total energy intake, alcohol intake, and fruit and vegetable consumption

   

3,950

All cases

1.01 (0.96-1.07)

 
   

NR

Advanced cases

1.15 (0.98-1.36)

 
  

Processed meat (bacon, red meat sausage, poultry sausage, luncheon meats, cold cuts, ham, hot dogs, meats added to mixtures, such as pizza, chili, lasagna, and stew)

 

Quintiles of intake: 5 vs. 1 22.6 g/1000 kcal vs. 1.6

  
   

4,196

All cases

1.02 (0.97-1.07)

 
   

NR

Advanced cases

1.22 (1.05-1.43)

 

Cross et al. 2005

PLCO Cancer Screening Trial

Red meat (all beef, pork, and lamb [processed & non-processed])

 

Quintiles of intake: 5 vs. 1

 

Age, race, study center, family hx of prostate cancer, hx of diabetes, number of screening exams during follow-up, smoking status, physical activity, aspirin use, BMI, and intake of total energy, supplemental vitamin E, lycopene

   

NR

All cases

0.91 (0.73-1.12)

 
   

NR

Incident cases

0.81 (0.62-1.06)

 
   

NR

Advanced cases

0.92 (0.66-1.29)

 
  

Processed meat (Ham, hot dogs, liver, cold cuts, sausage, bacon)

 

Quintiles of intake 5 vs. 1

  
   

NR

All cases

1.14 (0.93-1.39)

 
   

NR

Incident cases

1.16 (0.91-1.50)

 
   

NR

Advanced cases

1.37 (0.99-1.90)

 

Gann et al. 1994 *

Physician's Health Study

Beef, pork or lamb as a main dish

NR

Consumption: ≥5-6 times/wk vs. ≤1-3 times/month

2.51 (0.93-6.74)

Matched by age and smoking status

Hsing et al. 1990

Lutheran Brotherhood Society Cohort

Meat (beef, bacon, fresh pork, and smoked ham)

Mortalities

Intake (times/month)

 

Age and tobacco use

   

27

>39 vs. <17

0.8 (0.5-1.3)

 

Koutros et al. 2008

Agricultural Health Study (Iowa and North Carolina)

  

Quintiles of intake: 5 vs. 1

 

Adjusted for age, state of residence, race, family hx of prostate cancer, and smoking status

  

Red meat

105

All cases

1.10 (0.85-1.43)

 
   

95

Incident cases

1.11 (0.84-1.46)

 
   

21

Advanced cases

0.89 (0.50-1.60)

 
  

Bacon/sausage

140

All cases

0.98 (0.78-1.24)

 
   

125

Incident cases

0.90 (0.70-1.15)

 
   

21

Advanced cases

0.69 (0.40-1.18)

 

Le Marchand et al. 1994

Hawaii

Pork

NR

Quantile of intake 4 vs. 1 (range for cohort 0-118 g/wk)

1.1 (0.7-1.7)

Age, ethnicity, and income

  

Beef

 

Tertile of intake 3 vs. 1 (range for cohort 210-381 g/wk)

 

Age, ethnicity, and income by proportional hazards regression

   

NR

All cases

1.6 (1.1-2.4)

 
   

NR

Diagnosis age ≤72.5 yrs

2.2 (1.2-4.1)

 
   

NR

Diagnosis age >72.5 yrs

1.4 (0.8-2.5)

 
   

NR

Diagnosis age ≤72.5 yrs, localized stage prostate cancer

2.7 (NR)

 
   

NR

Diagnosis age >72.5 yrs, localized stage prostate cancer

2.0 (NR)

 
   

NR

Diagnosis age ≤72.5 yrs, regional and distant stage prostate cancer

1.4 (NR)

 
   

NR

Diagnosis age >72.5 yrs, regional and distant stage prostate cancer

0.8 (NR)

 
  

Processed meat

NR

Quantiles of intake 4 vs. 1(range for cohort 0-129 g/wk)

1.2 (0.8-1.9)

 

Michaud et al. 2001

Health Professionals Follow-Up Study

Red meat (processed meats; bacon; hot dogs; hamburger; beef, pork, or lamb as a sandwich, mixed dish or main dish)

 

Quintiles 5 vs. 1

0.91 (0.75-1.1)

Age, calories, calcium, smoking, tomato sauce, vigorous exercise, saturated fat and alpha-linolenic fat

   

315

Prostate cancer excluding stage A1

  
   

104

Advanced prostate cancer

1.15 (0.80-1.7)

 
   

55

Metastatic prostate cancer

1.50 (0.88-2.5)

Also adjusted for period, in addition to covariates above

  

Beef, pork or lamb (main dish)

38

Intake of 5+ vs. 0/wk, metastatic prostate cancer

1.35 (0.72-2.5)

Age, calories, calcium, smoking, tomato sauce, vigorous exercise, saturated and alpha linolenic fat

    

Intake of 2+ vs. 0/wk,

  
  

Beef, pork or lamb (sandwich or mixed dish)

64

Metastatic prostate cancer

0.96 (0.62-1.5)

 
  

Hamburger

68

Metastatic prostate cancer

1.08 (0.66-1.8)

 
  

Processed meats

71

Metastatic prostate cancer

1.39 (0.94-2.1)

Age, calories, calcium, smoking, tomato sauce, vigorous exercise, saturated fat, and alpha-linolenic fat

  

Bacon

50

Metastatic prostate cancer

1.33 (0.89-2.0)

 
  

Hot dogs

15

Metastatic prostate cancer

0.85 (0.48-1.5)

 

Mills et al. 1989

Seventh Day Adventists

Beef hamburger

43

Consumed ≥1 time/wk vs. never

1.07 (0.73-1.59)

Age

  

Beef steak

17

 

0.81 (0.72-1.50)

 
  

Other beef and veal

32

 

1.09 (0.71-1.67)

 
  

Beef index

63

 

1.21 (0.83-1.75)

 

Neuhouser et al. 2007

CARET

Red meat

 

Quartiles of intake: high vs. low

 

Age, energy intake, BMI, smoking, family hx of prostate cancer

   

NR

Prostate cancer

0.76-1.62§ (NR)

 

Park et al. 2007

Multiethnic Cohort Study

  

Quintile of intake: 5 vs. 1

  
  

Red meat (beef, pork, and lamb)

NR

Total prostate cancer

0.97 (0.87-1.07)

Time on study, ethnicity, family hx of prostate cancer, education, BMI, smoking status, energy intake

   

NR

Nonlocalized or high-grade cancer

0.95 (0.79-1.14)

 
   

226

African Americans

1.05 (0.86-1.27)

Time on study, family hx of prostate cancer, education, BMI, smoking status, energy intake

   

109

Japanese Americans

1.04 (0.82-1.31)

 
   

270

Latinos

0.87 (0.72-1.06)

 
   

115

Whites

0.83 (0.65-1.05)

 
  

Beef

NR

Total prostate cancer

0.98 (0.88-1.08)

Time on study, ethnicity, family hx of prostate cancer, education, BMI, smoking status, energy intake

   

NR

Nonlocalized or high-grade cancer

0.97 (0.81-1.16)

 
  

Pork

NR

Total prostate cancer

0.97 (0.88-1.08)

 
   

NR

Nonlocalized or high-grade cancer

0.92 (0.76-1.11)

 
  

Processed meat (processed red meat and processed poultry)

 

Quintile of intake: 5 vs. 1

  
   

NR

Total prostate cancer

1.01 (0.91-1.12)

Time on study, ethnicity, family hx of prostate cancer, education, BMI, smoking status, energy intake

   

NR

Nonlocalized or high-grade cancer

0.92 (0.77-1.11)

 
   

373

African Americans

1.00 (0.83-1.20)

Time on study, family hx of prostate cancer, education, BMI, smoking status, energy intake

   

181

Japanese Americans

1.09 (0.88-1.34)

 
   

134

Latinos

0.86 (0.69-1.08)

 
   

157

Whites

1.02 (0.82-1.27)

 

Rodriguez et al. 2006

Cancer Prevention Study II

Total processed plus unprocessed red meat (includes both processed meat and red meat)

 

Intake: ≥657 vs. <246 g/wk

 

Age at entry, total calorie intake, BMI, education, family hx of prostate cancer, hx of PSA testing, and hx of diabetes

   

27

All prostate cancer, Blacks

2.0 (1.0-4.2)

 
   

1,239

All prostate cancer, Whites

1.0 (0.9-1.0)

 
   

56

Metastatic prostate cancer, Whites

0.8 (0.5-1.3)

 
  

Unprocessed red meat

 

Intake: ≥423 vs. <137 g/wk

  
   

20

All prostate cancer, Blacks

1.7 (0.8-3.9)

 
   

1,557

All prostate cancer, Whites

1.0 (0.9-1.1)

 
   

69

Metastatic prostate cancer, Whites

0.8 (0.5-1.2)

 
  

Processed meats (includes both cooked processed meat and lunchmeat)

 

Intake ≥247 vs. <59 g/wk

  
   

28

All prostate cancer, Blacks

2.4 (1.2-4.9)

 
   

765

All prostate cancer, Whites

1.0 (0.9-1.1)

 
   

37

Metastatic prostate cancer, Whites

1.1 (0.7-1.7)

 
  

Cooked processed meat

 

Intake ≥165 vs. <38 g/wk

  
   

29

All prostate cancer, Blacks

2.7 (1.3-5.3)

 
   

369

All prostate cancer, Whites

1.0 (0.9-1.2)

 
   

21

Metastatic prostate cancer, Whites

1.2 (0.7-2.1)

 
  

Lunchmeat

 

Intake ≥56 g/wk vs. none

  
   

29

All prostate cancer, Blacks

1.0 (0.6-1.9)

 
   

1,845

All prostate cancer, Whites

1.0 (1.0-1.1)

 
   

88

Metastatic prostate cancer, Whites

1.0 (0.7-1.5)

 

Rohrmann et al. 2007

CLUE II

Red meat (hamburgers, beef, beef stew, pork, hot dogs, ham/lunch meats, bacon, sausages)

 

Tertile of daily consumption (3 vs. 1)

 

Age, energy intake, consumption of tomato products, BMI at age 21, and intake of saturated fat

   

51

Total prostate cancer

0.87 (0.59-1.32)

 
   

12

High-stage prostate cancer

0.87 (0.39-1.93)

 
   

17

Low-stage prostate cancer

0.60 (0.31-1.18)

 
  

Beef (beef, beef stew, pork, hot dogs, ham/lunch meats, bacon, sausages)

 

Consumption: >5 vs. ≤1 times/wk

  
   

84

Total prostate cancer

1.16 (0.74-1.81)

 
   

18

High-stage prostate cancer

0.83 (0.36-1.92)

 
   

35

Low-stage prostate cancer

1.72 (0.79-3.79)

 
  

Pork

 

Consumption: ≥1 times/wk vs. never

  
   

39

Total prostate cancer

1.17 (0.77-1.78)

 
   

12

High-stage prostate cancer

1.98 (0.87-4.53)

 
   

15

Low-stage prostate cancer

0.88 (0.46-1.70)

 
  

Processed meats

 

Consumption : >5 vs. ≤1 times/wk

  
   

96

Total prostate cancer

1.53 (0.98-2.39)

 
   

27

High-stage prostate cancer

2.24 (0.90-5.59)

 
   

32

Low-stage prostate cancer

1.30 (0.62-2.74)

 
    

Consumption : ≥1 vs. <1 times/wk

  
  

Sausages

43

Total prostate cancer

1.16 (0.79-1.73)

Age, energy intake, saturated fat intake, consumption of tomato products, and BMI at age 21

   

17

High-stage prostate cancer

2.83 (1.34-5.99)

 
   

14

Low-stage prostate cancer

0.75 (0.39-1.44)

 
  

Bacon

74

Total prostate cancer

1.32 (0.91-1.93)

 
   

22

High-stage prostate cancer

2.10 (0.97-4.53)

 
   

31

Low-stage prostate cancer

1.35 (0.74-2.44)

 
  

Ham/lunch meat

115

Total prostate cancer

1.54 (1.01-2.33)

 
   

30

High-stage prostate cancer

1.94 (0.82-4.56)

 
   

43

Low-stage prostate cancer

2.00 (0.94-4.25)

 
  

Hot dogs

45

Total prostate cancer

1.12 (0.73-1.73)

 
   

13

High-stage prostate cancer

1.71 (0.70-4.14)

 
   

18

Low-stage prostate cancer

0.96 (0.50-1.88)

 

Schuurman et al. 1999**

Netherlands Cohort Study

  

Continuous variables of 25 g/day increments

 

Age, family hx of prostate cancer, socioeconomic status, total fresh meat and poultry

  

Beef

NR

All tumors

1.00 (0.89-1.12)

 
   

NR

Localized tumors

0.95 (0.80-1.12)

 
   

NR

Advanced tumors

0.92 (0.77-1.10)

 
  

Pork

NR

All tumors

1.06 (0.96-1.18)

 
   

NR

Localized tumors

1.16 (1.00-1.34)

 
   

NR

Advanced tumors

1.06 (0.91-1.23)

 
  

Minced meat (beef and pork)

NR

All tumors

0.86 (0.74-1.01)

 
   

NR

Localized tumors

0.84 (0.66-1.07)

 
   

NR

Advanced tumors

0.90 (0.71-1.14)

 
    

Continuous variables of 5 g/day increments

  
  

Liver

NR

All tumors

0.92 (0.82-1.04)

 
   

NR

Localized tumors

0.99 (0.85-1.17)

 
   

NR

Advanced tumors

0.79 (0.63-0.99)

 
  

Other meat (horsemeat, lamb, mutton, and veal)

NR

All tumors

1.06 (0.99-1.15)

 
   

NR

Localized tumors

1.04 (0.93-1.16)

 
   

NR

Advanced tumors

1.09 (0.98-1.21)

 
  

Cured meat (boiled ham, bacon. Lean meat products including smoked beef, and other sliced cold meats)

123

Quintiles of intake 5 vs. 1 36 g/day vs. 0

1.37 (1.00-1.89)

Age, family hx of prostate cancer and socioeconomic status

   

NR

Continuous variables of 15 g/day increments Advanced tumors

1.00 (0.88-1.14)

 

Severson et al. 1989

Hawaii

Ham, bacon, sausage

35

≥5/vs. ≤1 times/wk

1.11 (0.75-1.65)

Age

Wu et al. 2006

US Health Professionals

Total red meat (hamburger, beef, lamb, and pork as main dish; beef, lamb, & pork as main dish or mixed dish)

 

Intake quintile 5 vs. 1

 

Age, height, smoking, family hx of prostate cancer, race, hx of vasectomy, vigorous exercise, BMI, alcohol intake, and total energy intake

   

41

Age <65 yrs old

2.12 (1.18-3.78)

 
   

72

Age ≥65 yrs old

1.21 (0.85-1.74)

 
  

Processed meats (salami, bologna, or other processed meat sandwiches; sausage, kielbasa, hot dogs, and bacon)

 

Intake quintile 5 vs. 1

  
   

34

Age <65 years old

0.85 (0.47-1.56)

 
   

79

Age ≥65 years old

1.51 (1.00-2.26)

 
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Nutrition Journal

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