title: Meat intake and bladder cancer risk in 2 prospective cohort studies.
abstract: BACKGROUND
  Nitrosamines, which are known bladder carcinogens, or their precursors are found in certain meat items, and concentrations of these compounds are especially high in bacon. Only 3 cohort studies, all with <100 case subjects, have examined the relation between meat intake and bladder cancer, and few studies have examined the relation of different meat types with bladder cancer.
  
  
  OBJECTIVE
  The aim was to examine the association between specific meat items and bladder cancer in 2 large prospective studies.
  
  
  METHODS
  We analyzed data from 2 cohorts with up to 22 y of follow-up and 808 incident bladder cancer cases. Detailed data on meat were obtained from multiple food-frequency questionnaires administered over time. Multivariate relative risks (RRs) and 95% CIs were estimated by using Cox proportional hazards models with control for potential confounders, including detailed smoking history.
  
  
  RESULTS
  Men and women with a high intake of bacon (>/=5 servings/wk) had an elevated risk of bladder cancer compared with those who never ate bacon (multivariate RR = 1.59; 95% CI = 1.06, 2.37), although the overall association was not statistically significant (P for trend = 0.06). However, the association with bacon was stronger and became statistically significant after the removal of individuals who indicated having "greatly" changed their red meat (men) or bacon (women) intake during the 10 y before baseline (multivariate RR = 2.10; 95% CI = 1.24, 3.55; P for trend = 0.006). A positive association was also detected for intake of chicken without skin, but not for chicken with skin or for other meats, including processed meats, hot dogs, and hamburgers.
  
  
  CONCLUSIONS
  In these 2 cohorts combined, frequent consumption of bacon was associated with an elevated risk of bladder cancer. Other studies with data on specific meat items are necessary to confirm our findings.
authors.affiliation: Department of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA, USA. dmichaud@hsph.harvard.edu
authors.forename: Dominique S
authors.initials: DS
authors.lastname: Michaud
authors.forename: Crystal N
authors.initials: CN
authors.lastname: Holick
authors.forename: Edward
authors.initials: E
authors.lastname: Giovannucci
authors.forename: Meir J
authors.initials: MJ
authors.lastname: Stampfer
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002273:Carcinogens / Q000008:administration & dosage; D015331:Cohort Studies; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008461:Meat Products / Q000009:adverse effects*; D008875:Middle Aged; D015999:Multivariate Analysis; D009602:Nitrosamines / Q000008:administration & dosage / Q000009:adverse effects*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D011795:Surveys and Questionnaires; D013552:Swine; D014481:United States / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000209:etiology
chemical_list: D002273:Carcinogens; D009602:Nitrosamines