Are meat and heme iron intake associated with pancreatic cancer? Results from the NIH-AARP diet and health cohort

Abstract

Several studies on pancreatic cancer have reported significant positive associations for intake of red meat but null associations for heme iron. We assessed total, red, white, and processed meat intake, meat cooking methods and doneness, and heme iron and mutagen intake in relation to pancreatic cancer in the NIH-AARP Diet and Health Study cohort. 322,846 participants (187,265 men; 135,581 women) successfully completed and returned the food frequency questionnaire between 1995–1996. After a mean follow-up of 9.2 years (up to 10.17 years), 1,417 individuals (895 men, 522 women) developed exocrine pancreatic cancer. Cox proportional hazard models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI), and trends were calculated using the median value of each quantile. Models incorporated age as the time metric and were adjusted for smoking history, BMI, self-reported diabetes, and energy-adjusted saturated fat. Pancreatic cancer risk significantly increased with intake of total meat (Q5 vs. Q1 HR=1.20, 95% CI 1.02–1.42, p-trend=0.03), red meat (HR=1.22, 95% CI 1.01–1.48, p-trend=0.02), high-temperature cooked meat (HR=1.21, 95% CI 1.00–1.45, p-trend=0.02), grilled/barbequed meat (HR=1.24, 95% CI 1.03–1.50, p-trend=0.007), well/very well done meat (HR=1.32, 95% CI 1.10–1.58, p-trend = 0.005), and heme iron from red meat (Q4 vs. Q1 HR=1.21, 95% CI 1.01–1.45, p-trend=0.04). When stratified by sex, these associations remained significant in men but not women except for white meat intake in women (HR = 1.33, 95% CI 1.02–1.74, p-trend = 0.04). Additional studies should confirm our findings that consuming heme iron from red meat increases pancreatic cancer risk.

The role of heme iron molecules derived from red and processed meat in the pathogenesis of colorectal carcinoma

“…Similarly, Smolinska and colleagues have shown carcinogenic effects of red meat in colon, following daily intakes of 50g or more (Smolinska and Paluszkiewicz, 2010). In addition to CRCs, high consumption of red and processed meat has also shown to be associated with increased incidence of many other carcinomas such as oesophageal, gastric,breast, pancreas and lung (Cross et al, 2011;Inoue-Choi et al, 2016;Lam et al, 2009;Taunk et al, 2016).Recently, following an assessment of over 800 studies across the world, the International Agency for Research on Cancer (IARC), a working group for cancer related studies of the World Health Organization (WHO), has confirmed that there is sufficient evidence for an association between (CRC) and consumption of processed meat (Bouvard et al, 2015).The IARC working group has classified A C C E P T E D M A N U S C R I P T processed meat as 'carcinogenic to humans'/ Group 1 and red meat as 'probably carcinogenic to humans' / Group2A (Bouvard et al, 2015;Tasevska et al, 2011). However, the IARC group has concluded that there is insufficient evidence to prove a strong association between consumption of unprocessed red meat and carcinogenesis, since the effect of the other confounding dietary factors such as salt and fat, food preparation methods and various lifestyle factors were not explicitly considered in the studies reviewed (Bouvard et al, 2015).…”

The Multifaceted Role of Heme in Cancer

“…The role of dietary heme in cancer has been highlighted in different types of carcinomas. Indeed, high consumption of red and processed meat has been associated with increased incidence of esophageal, gastric, breast, endometrial, pancreas and lung tumor (10)(11)(12)(13)(14)(15), while no clear link was found for bladder and prostate cancer (16)(17)(18). However, the majority of studies focused on the role of dietary heme in the pathogenesis of colorectal cancer (CRC), still a leading cause of cancer deaths in Western Countries (19)(20)(21).…”

Ingested nitrate and nitrite, disinfection by‐products, and pancreatic cancer risk in postmenopausal women

“…That study also found no associations with saturated fat intake overall or from dairy products specifically, but a significant risk associated with saturated fat intakes from red and processed meat. In the NIH‐AARP Diet and Health Study cohort ( N = 1,417 cases), a positive association between processed meat and pancreatic cancer was no longer significant in women after adjustment for saturated fat, although it remained among men . Two meta‐analyses reported an overall association between high consumption of red meat and processed meats and increased pancreatic cancer risk from case–control studies, but no such associations in cohort studies.…”

“…In the NIH-AARP Diet and Health Study cohort (N 5 1,417 cases), a positive association between processed meat and pancreatic cancer was no longer significant in women after adjustment for saturated fat, although it remained among men. 49 Two meta-analyses reported an overall association between high consumption of red meat 50,51 and processed meats 51 and increased pancreatic cancer risk from case-control studies, but no such associations in cohort studies. In the cohort studies, an association between red meat intake and pancreatic cancer risk was observed in men but not women, possibly because men have been demonstrated to have greater meat intake than women.…”