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How Does Intake of Unprocessed Red Meat and Processed Meat Impact Risk of Disease Recurrence and Mortality in Patients With Colon Cancer?


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In a prospective cohort study reported in JAMA Network Open, Erin L. Van Blarigan, ScD, and colleagues found that higher intake of unprocessed red meat or processed meat was not associated with poorer recurrence-free or overall survival in patients with stage III colon cancer.

As stated by the investigators, “The American Cancer Society and American Institute for Cancer Research recommend that cancer survivors limit intake of red and processed meats. This recommendation is based on consistent associations between red and processed meat intake and cancer risk, particularly risk of colorectal cancer, but fewer data are available on red and processed meat intake after cancer diagnosis.”

Study Details

The study included 1,011 patients from the CALGB 89803/Alliance trial who were enrolled between 1999 and 2001. Quartiles of unprocessed red meat and processed meat intake were assessed using a validated food frequency questionnaire during and 6 months after chemotherapy. The clinical database for the current analysis was frozen in November 2009, with data analyses finalized in December 2021.


In this cohort study, postdiagnosis intake of unprocessed red meat or processed meat was not associated with risk of recurrence or death among patients with stage III colon cancer.
— Erin L. Van Blarigan, ScD, and colleagues

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Key Findings

The median number of servings per week for lowest to highest quartiles were: 1.5, 2.6, 4.0, and 6.9 for unprocessed red meat and 0.7, 1.5, 2.7, and 5.2 for processed meat. During a median follow-up of 6.6 years (interquartile range = 1.9–7.5 years), 305 deaths and 81 cancer recurrences without death were observed.

In a multivariate model adjusted for age; sex; race/ethnicity; energy intake; T stage; number of positive lymph nodes; baseline performance status; chemotherapy treatment group; body mass index; physical activity; smoking status; aspirin use; and intake of alcohol, dark-meat fish, vitamin D, cereal fiber, high-fat dairy, and eggs, hazard ratios for the highest vs lowest quartiles of intake were: 0.53 (95% confidence interval [CI] = 0.38–0.75) for recurrence or death and 0.48 (95% CI = 0.33–0.70) for all-cause mortality for unprocessed red meat; and 0.82 (95% CI = 0.59–1.14) and 0.82 (95% CI = 0.57–1.17), respectively, for processed meat.

When total daily carbohydrate intake was added to the multivariate model, hazard ratios for the highest vs lowest quartiles of intake were: 0.84 (95% CI = 0.58­–1.23) for recurrence or death and 0.71 (95% CI = 0.47–1.07) for all-cause mortality for unprocessed red meat; and 1.05 (95% CI = 0.75–1.47) and 1.04 (95% CI = 0.72–1.51), respectively, for processed meat.

The investigators concluded, “In this cohort study, postdiagnosis intake of unprocessed red meat or processed meat was not associated with risk of recurrence or death among patients with stage III colon cancer.”

Dr. Van Blarigan, of the Department of Epidemiology and Biostatistics, University of California, San Francisco, is the corresponding author for the JAMA Network Open article.

Disclosure: The study was supported by the National Cancer Institute. For full disclosures of the study authors, visit jamanetwork.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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