Journal of the National Cancer Institute Advance Access originally published online on November 25, 2008
JNCI Journal of the National Cancer Institute 2008 100(23):1695-1706; doi:10.1093/jnci/djn386
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© The Author 2008. Published by Oxford University Press.
ARTICLES |
Fat, Protein, and Meat Consumption and Renal Cell Cancer Risk: A Pooled Analysis of 13 Prospective Studies
Affiliations of authors: Channing Laboratory (JEL, DJH, EC, WCW) and Division of Preventive Medicine (JEB, SMZ), Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA; Department of Epidemiology (DS, DJH, JEB, WCW, SASW), Department of Nutrition (DJH, WCW, SASW), and Department of Biostatistics (DS), Harvard School of Public Health, Boston, MA; Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Health Services, Bethesda, MD (DA, MFL, AS); City of Hope Comprehensive Cancer Center and Beckman Research Institute, City of Hope National Medical Center, Duarte, CA (LB); Department of Epidemiology, GROW—School for Oncology and Developmental Biology, University Maastricht, Maastricht, The Netherlands (PAvdB, LJS); Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia (DRE, GGG); Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo, NY (JLF, SG); Northern California Cancer Center, Fremont, CA (PLHR); Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden (NH, AW); Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland (SM); Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA (MLM); Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (ABM); Department of Urology, Mayo Clinic College of Medicine, Jacksonville, FL (ASP); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER); Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT (CS)
Correspondence to: Jung Eun Lee, ScD, Channing Laboratory, Brigham and Women's Hospital, and Harvard Medical School, 181 Longwood Ave, Boston, MA 02115 (e-mail: jung.lee{at}channing.harvard.edu).
Background: Results of several case–control studies suggest that high consumption of meat (all meat, red meat, or processed meat) is associated with an increased risk of renal cell cancer, but only a few prospective studies have examined the associations of intakes of meat, fat, and protein with renal cell cancer.
Methods: We conducted a pooled analysis of 13 prospective studies that included 530 469 women and 244 483 men and had follow-up times of up to 7–20 years to examine associations between meat, fat, and protein intakes and the risk of renal cell cancer. All participants had completed a validated food frequency questionnaire at study entry. Using the primary data from each study, we calculated the study-specific relative risks (RRs) for renal cell cancer by using Cox proportional hazards models and then pooled these RRs by using a random-effects model. All statistical tests were two-sided.
Results: A total of 1478 incident cases of renal cell cancer were identified (709 in women and 769 in men). We observed statistically significant positive associations or trends in pooled age-adjusted models for intakes of total fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, total protein, and animal protein. However, these associations were attenuated and no longer statistically significant after adjusting for body mass index, fruit and vegetable intake, and alcohol intake. For example, the pooled age-adjusted RR of renal cell cancer for the highest vs the lowest quintile of intake for total fat was 1.30 (95% confidence interval [CI] = 1.08 to 1.56; Ptrend = .001) and for total protein was 1.17 (95% CI = 0.99 to 1.38; Ptrend = .02). By comparison, the pooled multivariable RR for the highest vs the lowest quintile of total fat intake was 1.10 (95% CI = 0.92 to 1.32; Ptrend = .31) and of total protein intake was 1.06 (95% CI = 0.89 to 1.26; Ptrend = .37). Intakes of red meat, processed meat, poultry, or seafood were not associated with the risk of renal cell cancer.
Conclusions: Intakes of fat and protein or their subtypes, red meat, processed meat, poultry, and seafood are not associated with risk of renal cell cancer.
| CONTEXT AND CAVEATS Prior knowledge Epidemiological studies have produced inconsistent or insufficient evidence regarding associations between intakes of different types of fat, protein, and meat and the risk of renal cell cancer. Study design A pooled analysis of 1478 cases of renal cell cancer from 13 prospective studies to examine associations between meat, fat, and protein intakes and the risk of renal cell cancer. Contribution None of the types of fat or protein examined was associated with the risk of renal cell cancer after adjustment for several known risk factors in multivariable models. Implications Intakes of fat and protein or their subtypes, red meat, processed meat, poultry, and seafood are not associated with risk of renal cell cancer. Limitations Some bias due to measurement error was possible. The dietary assessment methods differed across studies. Effects of changes in intakes over time could not be examined because only a baseline measure of dietary intake was available for each study. From the Editors
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Manuscript received March 10, 2008; revised September 5, 2008; accepted September 29, 2008.
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