TY - JOUR
T1 - Meat and heme iron intake and risk of squamous cell carcinoma of the upper aero-digestive tract in the European Prospective Investigation into Cancer and Nutrition (EPIC)
AU - Steffen, Annika
AU - Bergmann, Manuela M.
AU - Sánchez, María Jośe
AU - Chirlaque, Maria Dolores
AU - Jakszyn, Paula
AU - Amiano, Pilar
AU - Quirós, J. Ramón
AU - Gurrea, Aurelio Barricarte
AU - Ferrari, Pietro
AU - Romieu, Isabelle
AU - Fedirko, Veronika
AU - Bueno-de-Mesquita, H. B.
AU - Siersema, Peter D.
AU - Peeters, Petra H.M.
AU - Khaw, Kay Tee
AU - Wareham, Nick
AU - Allen, Naomi E.
AU - Crowe, Francesca L.
AU - Skeie, Guri
AU - Hallmanns, Göran
AU - Johansson, Ingegerd
AU - Borgquist, Signe
AU - Ericson, Ulrika
AU - Egeberg, Rikke
AU - Tjnøneland, Anne
AU - Overvad, Kim
AU - Grote, Verena
AU - Li, Kuanrong
AU - Trichopoulou, Antonia
AU - Oikonomidou, Despoina
AU - Pantzalis, Menelaos
AU - Tumino, Rosario
AU - Panico, Salvatore
AU - Palli, Domenico
AU - Krogh, Vittorio
AU - Naccarati, Alessio
AU - Mouw, Traci
AU - Vergnaud, Anne Claire
AU - Norat, Teresa
AU - Boeing, Heiner
PY - 2012/12
Y1 - 2012/12
N2 - Background: Evidence from prospective studies on intake of meat and fish and risk of squamous cell carcinoma (SCC) of the upper aero-digestive tract (UADT) is scarce. We prospectively investigated the association of meat and fish intake with risk of SCC of the UADT and the possible mechanism via heme iron in the large multicenter European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Multivariable proportional hazards models were used to estimate relative risks (RR) of SCC of the UADT in relation to intake of total meat, as well as subtypes of meat, fish, and heme iron among 348,738 individuals from 7 European countries. Results: During an average follow-up of 11.8 years, a total of 682 incident cases of UADT SCC were accrued. Intake of processed meat was positively associated with risk of SCC of the UADT in the total cohort [highest vs. lowest quintile: RR = 1.41; 95% confidence interval (CI) = 1.03-1.94], however, in stratified analyses, this association was confined to the group of current smokers (highest vs. lowest quintile: RR = 1.89; 95% CI = 1.22-2.93). Red meat, poultry, fish, and heme iron were not consistently related to UADT SCC. Conclusion: Higher intake of processed meat was positively associated with SCC of the UADT among smokers. Although this finding was stable in various sensitivity analyses, we cannot rule out residual confounding by smoking. Confirmation in future studies and identification of biologic mechanisms is warranted. Impact: Smokers may further increase their risk for SCC of the UADT if they additionally consume large amounts of processed meat.
AB - Background: Evidence from prospective studies on intake of meat and fish and risk of squamous cell carcinoma (SCC) of the upper aero-digestive tract (UADT) is scarce. We prospectively investigated the association of meat and fish intake with risk of SCC of the UADT and the possible mechanism via heme iron in the large multicenter European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: Multivariable proportional hazards models were used to estimate relative risks (RR) of SCC of the UADT in relation to intake of total meat, as well as subtypes of meat, fish, and heme iron among 348,738 individuals from 7 European countries. Results: During an average follow-up of 11.8 years, a total of 682 incident cases of UADT SCC were accrued. Intake of processed meat was positively associated with risk of SCC of the UADT in the total cohort [highest vs. lowest quintile: RR = 1.41; 95% confidence interval (CI) = 1.03-1.94], however, in stratified analyses, this association was confined to the group of current smokers (highest vs. lowest quintile: RR = 1.89; 95% CI = 1.22-2.93). Red meat, poultry, fish, and heme iron were not consistently related to UADT SCC. Conclusion: Higher intake of processed meat was positively associated with SCC of the UADT among smokers. Although this finding was stable in various sensitivity analyses, we cannot rule out residual confounding by smoking. Confirmation in future studies and identification of biologic mechanisms is warranted. Impact: Smokers may further increase their risk for SCC of the UADT if they additionally consume large amounts of processed meat.
UR - http://www.scopus.com/inward/record.url?scp=84871340869&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-12-0835
DO - 10.1158/1055-9965.EPI-12-0835
M3 - Article
C2 - 23033453
AN - SCOPUS:84871340869
SN - 1055-9965
VL - 21
SP - 2138
EP - 2148
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 12
ER -