A Prospective Analysis of Red and Processed Meat Intake in Relation to Colorectal Cancer Incidence in the Black Women's Health Study

Abstract

Abstract Objectives African Americans have the highest incidence of colorectal cancer (CRC) of any racial/ethnic group in the US. High intake of red and processed meats has been shown to increase CRC risk in populations of European ancestry, but evidence in African American populations is limited. The association between saturated and monounsaturated fatty acid intakes, the primary types of fat in red and processed meat, and CRC is inconclusive. Thus, we prospectively assessed the intake of red and processed meats and dietary saturated and monounsaturated fatty acids in relation to CRC risk, utilizing the Black Women's Health Study (BWHS, 1995–2018). Methods Dietary data were derived from validated food frequency questionnaires completed in 1995 and 2001 by 52,695 BWHS participants. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression adjusted for energy, fiber, and discretionary fat. Results Over a median follow-up of 22 years, 564 women developed incident CRC. Total red meat intake was associated with a 25% increased risk of CRC per 100 g/day (HR = 1.25; 95% CI: 0.94–1.66), which was primarily due to intake of unprocessed red meat (HR = 1.33, 95% CI: 1.05–1.70). Processed meat and total saturated and monounsaturated fatty acid intakes were not associated with an increased risk of CRC. Conclusions Unprocessed red meat intake was associated with an increased risk of CRC in this cohort of African American women. The strong evidence, now including African American women, that red meat plays a role in the etiology of CRC suggests opportunities for prevention. Funding Sources This research was funded by National Institutes of Health grants U01 CA164974 and R01 CA058420, the Karin Grunebaum Cancer Research Foundation, and the Boston University Peter Paul Career Development Professorship.