Meat, fish, and colorectal cancer risk: The European prospective investigation into cancer and nutrition

Teresa Norat, Sheila Bingham, Pietro Ferrari, Nadia Slimani, Mazda Jenab, Mathieu Mazuir, Kim Overvad, Anja Olsen, Anne Tjønneland, Francoise Clavel, Marie Christine Boutron-Ruault, Emmanuelle Kesse, Heiner Boeing, Manuela M. Bergmann, Alexandra Nieters, Jakob Linseisen, Antonia Trichopoulou, Dimitrios Trichopoulos, Yannis Tountas, Franco BerrinoDomenico Palli, Salvatore Panico, Rosario Tumino, Paolo Vineis, H. Bas Bueno-de-Mesquita, Petra H M Peeters, Dagrun Engeset, Eiliv Lund, Guri Skeie, Eva Ardanaz, Carlos González, Carmen Navarro, J. Ramón Quirós, María José Sanchez, Göran Berglund, Irene Mattisson, Göran Hallmans, Richard Palmqvist, Nicholas E. Day, Kay Tee Khaw, Timothy J. Key, Miguel San Joaquin, Bertrand Hémon, Rodolfo Saracci, Rudolf Kaaks, Elio Riboli

Research output: Contribution to journalArticlepeer-review


Background: Current evidence suggests that high red meat intake is associated with increased colorectal cancer risk. High fish intake may be associated with a decreased risk, but the existing evidence is less convincing. Methods: We prospectively followed 478 040 men and women from 10 European countries who were free of cancer at enrollment between 1992 and 1998. Information on diet and lifestyle was collected at baseline. After a mean follow-up of 4.8 years, 1329 incident colorectal cancers were documented. We examined the relationship between intakes of red and processed meat, poultry, and fish and colorectal cancer risk using a proportional hazards model adjusted for age, sex, energy (nonfat and fat sources), height, weight, work-related physical activity, smoking status, dietary fiber and folate, and alcohol consumption, stratified by center. A calibration substudy based on 36 994 subjects was used to correct hazard ratios (HRs) and 95% confidence intervals (CIs) for diet measurement errors. All statistical tests were two-sided. Results: Colorectal cancer risk was positively associated with intake of red and processed meat (highest [>160 g/day] versus lowest [trend = .03) and inversely associated with intake of fish (>80 g/day versus trendtrend = .001 and HR = 1.55, 95% CI = 1.19 to 2.02, Ptrend = .001 before and after calibration, respectively) and for fish (per 100 g increase HR = 0.70, 95% CI = 0.57 to 0.87, Ptrendtrend = .003; before and after correction, respectively). In this study population, the absolute risk of development of colorectal cancer within 10 years for a study subject aged 50 years was 1.71% for the highest category of red and processed meat intake and 1.28% for the lowest category of intake and was 1.86% for subjects in the lowest category of fish intake and 1.28% for subjects in the highest category of fish intake. Conclusions: Our data confirm that colorectal cancer risk is positively associated with high consumption of red and processed meat and support an inverse association with fish intake.

Original languageEnglish
Pages (from-to)906-916
Number of pages11
JournalJournal of the National Cancer Institute
Issue number12
Publication statusPublished - Jun 2005

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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