Pre-diagnostic meat and fibre intakes in relation to colorectal cancer survival in the European Prospective Investigation into Cancer and Nutrition.
Ward HA., Norat T., Overvad K., Dahm CC., Bueno-de-Mesquita HB., Jenab M., Fedirko V., van Duijnhoven FJ., Skeie G., Romaguera-Bosch D., Tjønneland A., Olsen A., Carbonnel F., Affret A., Boutron-Ruault MC., Katzke V., Kühn T., Aleksandrova K., Boeing H., Trichopoulou A., Lagiou P., Bamia C., Palli D., Sieri S., Tumino R., Naccarati A., Mattiello A., Peeters PH., Weiderpass E., Åsli LA., Jakszyn P., Ramón Quirós J., Sánchez MJ., Dorronsoro M., Huerta JM., Barricarte A., Jirström K., Ericson U., Johansson I., Gylling B., Bradbury KE., Khaw KT., Wareham NJ., Stepien M., Freisling H., Murphy N., Cross AJ., Riboli E.
Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (P for heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.