Red meat, dietary nitrosamines, and heme iron and risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC).
BACKGROUND
Previous epidemiologic studies found inconsistent results for the association between red meat intake, nitrosamines [NDMA: N-nitrosodimethylamine, and ENOC (endogenous nitroso compounds)], and the risk of bladder cancer. We investigated the association between red meat consumption, dietary nitrosamines, and heme iron and the risk of bladder cancer among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC).


METHODS
Data on food consumption and complete follow-up for cancer occurrence were available for a total of 481,419 participants, recruited in 10 European countries. Estimates of HRs were obtained by proportional hazard models, stratified by age at recruitment, gender, and study center and adjusted for total energy intake, smoking status, lifetime intensity of smoking, duration of smoking, educational level, and BMI.


RESULTS
After a mean follow-up of 8.7 years, 1,001 participants were diagnosed with bladder cancer. We found no overall association between intake of red meat (log2 HR: 1.06; 95% CI: 0.99-1.13), nitrosamines (log2 HR: 1.09; 95% CI: 0.92-1.30 and HR: 0.98; 95% CI: 0.92-1.05 for ENOC and NDMA, respectively) or heme iron (log2 HR: 1.05; 95 CI: 0.99-1.12) and bladder cancer risk. The associations did not vary by sex, high- versus low-risk bladder cancers, smoking status, or occupation (high vs. low risk).


CONCLUSIONS
Our findings do not support an effect of red meat intake, nitrosamines (endogenous or exogenous), or heme iron intake on bladder cancer risk.
Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, AV gran via 199 (08907), L'Hospitalet de Llobregat, Barcelona, Spain. paujak@iconcologia.net
Paula
P
Jakszyn
Carlos A
CA
González
Leila
L
Luján-Barroso
Martine M
MM
Ros
H Bas
HB
Bueno-de-Mesquita
Nina
N
Roswall
Anne M
AM
Tjønneland
Frederike L
FL
Büchner
Lars
L
Egevad
Kim
K
Overvad
Ole
O
Raaschou-Nielsen
Françoise
F
Clavel-Chapelon
Marie-Christine
MC
Boutron-Ruault
Marina S
MS
Touillaud
Jenny
J
Chang-Claude
Naomi E
NE
Allen
Lambertus A
LA
Kiemeney
Timothy J
TJ
Key
Rudolf
R
Kaaks
Heiner
H
Boeing
Steffen
S
Weikert
Antonia
A
Trichopoulou
Eleni
E
Oikonomou
Dimosthenis
D
Zylis
Domenico
D
Palli
Franco
F
Berrino
Paolo
P
Vineis
Rosario
R
Tumino
Amalia
A
Mattiello
Petra H M
PH
Peeters
Christine L
CL
Parr
Inger T
IT
Gram
Guri
G
Skeie
Maria-Jose
MJ
Sánchez
Nerea
N
Larrañaga
Eva
E
Ardanaz
Carmen
C
Navarro
Laudina
L
Rodríguez
David
D
Ulmert
Roy
R
Ehrnström
Göran
G
Hallmans
Borje
B
Ljungberg
Andrew Wilfred
AW
Roddam
Sheila A
SA
Bingham
Kay-Tee
KT
Khaw
Nadia
N
Slimani
Paolo A
PA
Boffetta
Mazda
M
Jenab
Traci
T
Mouw
Dominique S
DS
Michaud
Elio
E
Riboli
D004032:Diet; D005060:Europe / Q000453:epidemiology; D006418:Heme / Q000378:metabolism; D006801:Humans; D019266:Iron, Dietary / Q000008:administration & dosage* / Q000378:metabolism; D008460:Meat; D009602:Nitrosamines / Q000008:administration & dosage* / Q000378:metabolism / Q000506:poisoning; D011446:Prospective Studies; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000209:etiology
D019266:Iron, Dietary; D009602:Nitrosamines; D006418:Heme