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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)