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Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-0699. [Epub ahead of print]

Reduction of Red and Processed Meat Intake and Cancer Mortality and Incidence: A Systematic Review and Meta-analysis of Cohort Studies.

Author information

1
Chosun University, Gwangju, Republic of Korea (M.A.H.).
2
McMaster University, Hamilton, Ontario, Canada (D.Z., G.H.G., G.L., N.R., M.K.P., M.Z., J.J.B.).
3
Dalhousie University, Halifax, Nova Scotia, Canada, and Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands (R.W.V.).
4
Science and Technology Institute, Universidade Estadual Paulista, São José dos Campos, São Paulo, Brazil, and Dalhousie University, Halifax, Nova Scotia, Canada (R.E.).
5
Beijing University of Chinese Medicine, Beijing, China (Y.Z.).
6
Aseer Central Hospital, Abha, Saudi Arabia (A.A.).
7
Jagiellonian University Medical College, Kraków, Poland (D.S.).
8
Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute Sant Pau, and CIBER de Epidemiología y Salud Pública, Barcelona, Spain (C.V., M.R.).
9
University of Sorocaba, Sorocaba, Sao Paulo, Brazil (L.C.L.).
10
University of British Columbia, Vancouver, British Columbia, Canada (D.S.).
11
Jagiellonian University Medical College, Krakow, Poland (M.M.B.).
12
McMaster University, Hamilton, Ontario, Canada, and Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute Sant Pau, and CIBER de Epidemiología y Salud Pública, Barcelona, Spain (P.A.).
13
Dalhousie University, Halifax, Nova Scotia, and McMaster University, Hamilton, Ontario, Canada (B.C.J.).

Abstract

Background:

Cancer incidence has continuously increased over the past few centuries and represents a major health burden worldwide.

Purpose:

To evaluate the possible causal relationship between intake of red and processed meat and cancer mortality and incidence.

Data Sources:

Embase, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, and ProQuest from inception until July 2018 and MEDLINE from inception until April 2019 without language restrictions.

Study Selection:

Cohort studies that included more than 1000 adults and reported the association between consumption of unprocessed red and processed meat and cancer mortality and incidence.

Data Extraction:

Teams of 2 reviewers independently extracted data and assessed risk of bias; 1 reviewer evaluated the certainty of evidence, which was confirmed or revised by the senior reviewer.

Data Synthesis:

Of 118 articles (56 cohorts) with more than 6 million participants, 73 articles were eligible for the dose-response meta-analyses, 30 addressed cancer mortality, and 80 reported cancer incidence. Low-certainty evidence suggested that an intake reduction of 3 servings of unprocessed meat per week was associated with a very small reduction in overall cancer mortality over a lifetime. Evidence of low to very low certainty suggested that each intake reduction of 3 servings of processed meat per week was associated with very small decreases in overall cancer mortality over a lifetime; prostate cancer mortality; and incidence of esophageal, colorectal, and breast cancer.

Limitation:

Limited causal inferences due to residual confounding in observational studies, risk of bias due to limitations in diet assessment and adjustment for confounders, recall bias in dietary assessment, and insufficient data for planned subgroup analyses.

Conclusion:

The possible absolute effects of red and processed meat consumption on cancer mortality and incidence are very small, and the certainty of evidence is low to very low.

Primary Funding Source:

None. (PROSPERO: CRD42017074074).

PMID:
31569214
DOI:
10.7326/M19-0699

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