Inconsistent results regarding the association between red and processed meat intake and the risk of colorectal adenoma (CRA), the precursor of colorectal cancer (CRC), have been reported. To provide a quantitative assessment of this association, we summarized the evidence from observational studies. Relevant studies were identified in MEDLINE and EMBASE until December 31, 2011. Summary relative risks (SRRs) with 95% confidence intervals (CIs) were pooled with a random-effects model. Between-study heterogeneity was assessed using the Cochran's Q and I 2 statistics. A total of 21 studies (16 casecontrol studies and five cohort/nested case-control studies) were included in this meta-analysis. The SRRs of CRA were 1.36 (95% CI 5 1.17-1.58) for every 100 g/day increase in red meat intake, and 1.24 (95% CI 5 1.12-1.36) for the highest versus the lowest level of red meat intake. Nonlinear dose-response meta-analysis indicated that CRA risk increased approximately linearly with increasing intake of red meat up to~90 g/day, where the curve reached its plateau. Subgrouped analyses revealed that the increased risk of CRA with intake of red meat was independent of geographic locations, design and confounders. The SRRs of CRA was 1.28 (95% CI 5 1.03-1.60) for per 50 g/day increase in processed meat intake, and 1.17 (95% CI 5 1.08-1.26) for the highest versus the lowest level of processed meat intake. Increased intake of red and processed meat is associated with significantly increased risk of CRA.The incidence of and mortality from colorectal cancer (CRC) have been on the rise worldwide. 1 Annually, $1 million new cases of CRC are diagnosed, and nearly 530,000 individuals may die from this disease, equivalent to $8% of all cancer-related deaths worldwide.1 The World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) concluded in a report published in 2007 that high consumption of red and processed meat convincingly increases the risk of CRC.2 In this regard, a more recent meta-analysis of 24 prospective studies of CRC showed an increased risk of 17% (95% confidence interval [CI] ¼ 5-31%) per 100 g/day increased intake of red meat and of 18% (95% CI ¼ 10-28) per 50 g/day increased intake of processed meat.3 One underlying cause might be the formation of heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) during cooking or processing of meat, both of which are potent mutagens in rodents and humans. [4][5][6][7] Additionally, heme iron from red meat might be another potential risk factor for CRC development.
8It has been established that most CRCs arise from colorectal adenoma (CRA) by a process referred to as the adenoma-carcinoma sequence.9 On the basis of this theory, we may assume that adenoma and carcinoma share a common etiology and similar epidemiological features. Therefore, better information about risk factors for adenomas might permit more rational development of intervention studies with adenomas as end points.