title: Systematic review with meta-analysis: meat consumption and the risk of hepatocellular carcinoma.
abstract: BACKGROUND
  The association between meat consumption and the risk of hepatocellular carcinoma (HCC) is still inconclusive.
  
  
  OBJECTIVE
  To conduct a systematic review and meta-analysis to quantitatively assess the relationship between meat intake and the risk of HCC.
  
  
  METHODS
  We searched the PubMed, Web of Science and EMBASE databases for relevant studies published before July 2013. The summary relative risks were pooled using the fixed-effects model when no substantial heterogeneity was detected, otherwise, the random-effects model was used. Heterogeneity and publication bias were also analysed.
  
  
  RESULTS
  Finally, seven cohort studies and 10 case-control studies were included. The pooled relative risks (RRs) of HCC for the highest vs. lowest consumption levels were 1.10 (95% confidence interval, CI: 0.85-1.42) for red meat, 1.01 (95% CI: 0.79-1.28) for processed meat and 0.97 (95% CI: 0.85-1.11) for total meat. Moreover, white meat and fish consumption were found to be inversely associated with HCC risk, the summary RRs were 0.69 (95% CI: 0.58-0.81) and 0.78 (95% CI: 0.67-0.90) respectively, and the results remained quite stable after stratification by the confounding factors.
  
  
  CONCLUSIONS
  The present meta-analysis indicates that a high level of white meat or fish consumption can reduce the risk of HCC significantly, while intake of red meat, processed meat or total meat is not associated with HCC risk. Our findings suggest that dietary intervention may be a promising approach for prevention of HCC, which still need to be confirmed by further well-designed prospective studies and experimental research.
authors.affiliation: Department of Radiation Therapy, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: J
authors.initials: J
authors.lastname: Luo
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.forename: K
authors.initials: K
authors.lastname: Lu
authors.forename: Z
authors.initials: Z
authors.lastname: Tang
authors.forename: P
authors.initials: P
authors.lastname: Liu
authors.forename: L
authors.initials: L
authors.lastname: Liu
authors.forename: Y
authors.initials: Y
authors.lastname: Zhu
mesh_terms: D000818:Animals; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology; D005247:Feeding Behavior; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008460:Meat / Q000009:adverse effects; D012306:Risk