Consumption of Processed Meat and Unprocessed Red Meat and Risk of Bladder Cancer: A Pooled Analysis of 30 Cohort Studies
Year: 2026
Type: article
Abstract: Background: Processed meat and unprocessed red meat are considered carcinogenic and ‘probably carcinogenic’ to humans, respectively, but findings for bladder cancer remain inconsistent. Objectives: We assessed associations between processed meat and unprocessed red meat intake and bladder cancer risk using data from the Pooling Project of Prospective Studies of Diet and Cancer. Methods: Associations with bladder cancer risk were assessed using individual-level data from 30 cohort studies from North America, Europe, Australia and Asia. Diet was assessed at enrolment using validated food frequency questionnaires or diet histories. Following a pre-specified analysis plan, study- and sex-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression, adjusted for smoking status and duration and other potential confounders, and pooled using inverse-variance-weighted random-effects meta-analysis. Results: During median follow-up across cohorts of 8–29 years, among 2,575,971 participants, 20,780 were diagnosed with bladder cancer. Processed meat intake was associated with increased bladder cancer risk (HR comparing ≥40 with <5 g/day = 1.08; 95% CI: 1.02–1.15; HR per 20 g/day = 1.02; 95% CI: 1.00–1.03). Weaker evidence of association with increased risk was also observed for unprocessed red meat (HR comparing ≥100 with <20 g/day = 1.06; 95% CI: 1.00–1.13; HR per 50 g/day = 1.01; 95% CI: 0.99–1.03). There was no evidence of heterogeneity by study, sex, or region. Conclusions: Higher intakes of processed meat and unprocessed red meat were associated with a small increase in risk of bladder cancer. These findings are consistent with existing public health recommendations to limit consumption of red and processed meat.
Source: Cancers
Authors: Ziyu Wang, Nina Afshar, Allison M. Hodge, Harindra Jayasekara, Stella Koutros, Piet A. van den Brandt, Alicja Wolk, Molin Wang, Tao Hou, Hans-Olov Adami, Agneta Åkesson, Chrisa Arcan, Kimberly A. Bertrand, Marisa Bittoni, David Bogumil, Hui Cai, Amanda J. Cross, A. Heather Eliassen, Jo L. Freudenheim, Gretchen L. Gierach, Edward L. Giovannucci, Wen-Yi Huang, Paula Jakszyn, Rieko Kanehara, Victoria A. Kirsh, Woon-Puay Koh, Candyce H. Kroenke, James V. Lacey, Linda M. Liao, Erikka Loftfield, Chaoran Ma, Loic Le Marchand, Maria Elena Martinez, Anthony B. Miller, Steven C. Moore, Lorelei A. Mucci, Heather M. Munro, Marian L. Neuhouser, Jessica L. Petrick, Jenny N. Poynter, Mark A. Preston, Anna Prizment, Samantha Rees, Kim Robien, Thomas E. Rohan, Sven Sandin, Norie Sawada, Eva S. Schernhammer, Marissa M. Shams-White, Martha J. Shrubsole, Xiao-Ou Shu, Rashmi Sinha, Sabina Sieri, Mingyang Song, Meir J. Stampfer, Rachael Z. Stolzenberg-Solomon, Matthew Triplette, Caroline Y. Um, Kala Visvanathan, Trang VoPham, Fenglei Wang, Renwei Wang, Sophia S. Wang, Ying Wang, Elisabete Weiderpass, Lynne Wilkens, Walter C. Willett, Jian-Min Yuan, Wei Zheng, Nathaniel Rothman, Brigid M. Lynch, Debra T. Silverman, Stephanie A. Smith-Warner, Roger L. Milne
Institutions: The University of Melbourne, Cancer Council Victoria, Monash University, National Institutes of Health, Division of Cancer Epidemiology and Genetics, Maastricht University, Karolinska Institutet, Brigham and Women's Hospital, Harvard University, University of Oslo, Boston University, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, University of Southern California, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Imperial College London, University at Buffalo, State University of New York, Institut d'Investigació Biomédica de Bellvitge, Institut Català d'Oncologia, National Cancer Centre Japan, National Cancer Center Institute for Cancer Control, Ontario Institute for Cancer Research, University of Toronto, National University of Singapore, Kaiser Permanente, Kaiser Permanente Northern California, City Of Hope National Medical Center, City of Hope, University of Massachusetts Amherst, University of Hawaii Cancer Center, University of California San Diego, American Cancer Society, Fred Hutch Cancer Center, University of Minnesota, Dana-Farber Cancer Institute, Mass General Brigham, George Washington University, Albert Einstein College of Medicine, Medical University of Vienna, Fondazione IRCCS Istituto Nazionale dei Tumori, Johns Hopkins University, Sidney Kimmel Comprehensive Cancer Center, University of Pittsburgh, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Centre international de recherche sur le cancer, University of Hawaiʻi at Mānoa, University of Hawaii System, Monash Health
Language: English
Topic: Nutritional Studies and Diet
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,499
Funders: U.S. Department of Health and Human Services, Pennsylvania Department of Health, California Department of Public Health, Women's Health Initiative, Emory University, Arizona Department of Health Services, Division of Cancer Prevention, National Cancer Institute, Compagnia di San Paolo, Universitetet i Tromsø, Rutgers Cancer Institute of New Jersey, Louisiana State University, Deutsches Krebsforschungszentrum, World Cancer Research Fund International, Texas Department of State Health Services, Cancer Research UK, National Institute for Health and Care Research, European Commission, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, ZonMw, Bundesministerium für Bildung und Forschung, Cancerfonden, Ministerie van Volksgezondheid, Welzijn en Sport, Ministero della Salute, Ministerio de Economía y Competitividad, Ministero dell’Istruzione, dell’Università e della Ricerca, Ministry of Health, Labour and Welfare, Ligue Contre le Cancer, Vetenskapsrådet, KWF Kankerbestrijding, Associazione Italiana per la Ricerca sul Cancro, Deutsche Krebshilfe, Medical Research Council Canada, Institut Gustave-Roussy, Mutuelle Générale de l'Education Nationale, Wereld Kanker Onderzoek Fonds, National Institutes of Health, Centers for Disease Control and Prevention, Medical Research Council, World Cancer Research Fund, National Health and Medical Research Council, Cancer Council Victoria, National Medical Research Council, Instituto de Salud Carlos III, NIHR Imperial Biomedical Research Centre, School of Public Health, Imperial College London, National Institute on Aging, National Heart, Lung, and Blood Institute, National Cancer Institute, Division of Cancer Epidemiology and Genetics, National Cancer Institute
Awards: G105542917, Aetiology of type 2 diabetes and related metabolic disorders, G1101309989, G1102409361, G112615860, G1131279855, G1136667113, G1171225221, G1211708387, G1257877605, G1267744492, G1279123088, G1308150120, G1323150676, G1323892811, G1338486137, G1344543532, G1345005340, G1364241766, G1375034920, G1394359342, G1416987869, G1466874331, G1549970566, G1556458740, G1596968099, G1602600267, G1617294366, G1623198288, G1623279619, G1691963278, G1706282694, G1718233269, G175912426, G1793365030, G1802698707, G1837345911, G1851901423, G1880787370, G1889749614, G1889983372, G1892934672, Breast and Other Cancers in the California Teachers Cohort, G1913926447, SIMPLER, G1953801536, G2042260859, G2046878580, G205021445, G2057116721, G2078923067, G2127934866, G2130387517, G2177915516, G2181795046, G2185877915, G2231886490, G2241564663, G2252884675, G2342228987, G2345209562, G2375506761, G2383877542, G2394586229, G2419028985, G2454123149, Health 2020, G2558524529, Prospective studies of cancer etiology and prevention in Shanghai and Singapore, G2596364618, G2599035886, G2629953696, G2638395328, G2691247007, G2703649825, G2714613917, G2719760564, G2722284752, G2745390170, New Biospecimens to Enhance Research in the California Teachers Study Cohort, G2771691379, G2791473063, G2791572270, G2797338341, G2798791669, G2806776963, G2832588595, G2882226375, G2889031132, G2914729858, G2940262985, G2974529408, G2978753608, G2982411879, G2982591042, G300440387, MARYLAND CANCER PREVENTION AND CONTROL PROGRAM - THE GOAL OF THE MARYLAND CANCER PREVENTION AND CONTROL PROGRAM IS TO IMPLEMENT CANCER PREVENTION AND CONTROL PROGRAMS TO REDUCE MORBIDITY, MORTALITY, AND RELATED HEALTH DISPARITIES IN MARYLAND. PROGRAM 1: NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM THE MARYLAND BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM (MBCCEDP) WILL IMPLEMENT A COMPREHENSIVE, DATA-DRIVEN, AND HEALTH EQUITY-FOCUSED APPROACH TO DECREASE BREAST AND CERVICAL CANCER DISPARITIES, MORBIDITY, AND MORTALITY IN THE STATE OF MARYLAND. MBCCEDP OVERSEES 16 DIRECT SCREENING PROGRAMS ACROSS THE STATE THAT PROVIDE VULNERABLE WOMEN WITH QUALITY BREAST AND CERVICAL CANCER SCREENING, DIAGNOSTIC, AND PATIENT NAVIGATION SERVICES. MBCCEDP WORKS WITH STATE, REGIONAL, AND LOCAL PARTNERS TO INCREASE CLIENT RECRUITMENT EFFORTS AND LINK WOMEN TO APPROPRIATE RESOURCES SUCH AS A MEDICAL HOME AND HEALTH INSURANCE MARKETPLACES. ADDITIONALLY, MBCCEDP PARTNERS WITH HEALTH SYSTEMS AND PRIMARY CARE CLINICS TO INCORPORATE SUSTAINABLE EVIDENCE-BASED INTERVENTIONS INTO THEIR STANDARD OF CARE. MBCCEDP WILL WORK TOWARDS THE GOAL OF ELIMINATING DISPARITIES IN BREAST AND CERVICAL CANCER SCREENING AND OUTCOMES. MBCCEDP SERVES LOW-INCOME, UNINSURED AND UNDERINSURED WOMEN IN MARYLAND. HOWEVER, AS BLACK AND AFRICAN AMERICAN WOMEN IN MARYLAND EXPERIENCE SIGNIFICANTLY HIGHER LATE-STAGE DIAGNOSES AND HIGHER MORTALITY RATES COMPARED TO OTHER GROUPS, MBCCEDP WILL ALLOCATE RESOURCES, ENGAGE PARTNERS, AND MONITOR OUTCOMES TO PRIORITIZE THE BLACK AND AFRICAN AMERICAN POPULATION UNDER THIS COOPERATIVE AGREEMENT. THE HISPANIC POPULATION, WHICH MAKES UP A LARGE PERCENTAGE OF UNINSURED MARYLANDERS AND FACES ENGLISH-PROFICIENCY AND OTHER BARRIERS TO HEALTH CARE ACCESS, WILL BE A SECOND TARGET POPULATION FOR MBCCEDP. PROGRAM 2: NATIONAL COMPREHENSIVE CANCER CONTROL PROGRAM THE GOAL OF THE MARYLAND COMPREHENSIVE CANCER CONTROL PROGRAM (MCCCP) IS TO ADDRESS CANCER PREVENTION AND CONTROL ISSUES IN THE STATE OF MARYLAND BY CONVENING STAKEHOLDERS, USING AND SHARING SURVEILLANCE AND OTHER DATA, AND IMPLEMENTING FORMAL PLANS TO REDUCE THE BURDEN OF CANCER IN THE STATE. MCCCP FOCUSES ON IMPLEMENTING EVIDENCE-BASED INTERVENTIONS TO INCREASE AND IMPROVE PRIMARY PREVENTION, EARLY DETECTION AND SCREENING, AND THE HEALTH AND WELLBEING OF CANCER SURVIVORS. MCCCP ESTABLISHED THE MARYLAND CANCER COLLABORATIVE (MCC) IN 2011, BRINGING TOGETHER DIVERSE STAKEHOLDERS TO DEVELOP AND IMPLEMENT THE MARYLAND COMPREHENSIVE CANCER CONTROL PLAN, WHICH GUIDES CANCER PREVENTION AND CONTROL PRIORITIES IN THE STATE OF MARYLAND. MCCCP WILL MAINTAIN, SUPPORT, AND ENGAGE THE MCC AND MCC WORKGROUPS THROUGHOUT THE FIVE-YEAR PROJECT PERIOD. MCCCP WILL ALSO ESTABLISH, MAINTAIN, AND/OR SUPPORT OTHER ACTIVE STAKEHOLDER GROUPS IN MARYLAND, INCLUDING THE PATIENT NAVIGATION NETWORK, HUMAN PAPILLOMAVIRUS (HPV) TASK FORCE, MARYLAND COLORECTAL CANCER TASK FORCE, AND LUNG CANCER COLLABORATIVE. INTERNALLY, MCCCP WILL CONTINUE TO FOSTER REGULAR COLLABORATION AMONG OTHER CENTERS FOR DISEASE CONTROL AND PREVENTION- AND STATE-FUNDED CANCER AND CHRONIC DISEASE PROGRAMS, SHARING THE MCCCP’S EXPERTISE IN IMPLEMENTING POLICY, SYSTEMS, AND ENVIRONMENTAL APPROACHES AND CLINICAL-COMMUNITY LINKAGES. PROGRAM 3: NATIONAL PROGRAM OF CANCER REGISTRIES THE MARYLAND CANCER REGISTRY (MCR) AIMS TO REDUCE THE BURDEN OF CANCER IN MARYLAND. UNDER THIS COOPERATIVE AGREEMENT, THE MCR WILL WORK TOWARD THIS GOAL BY CONTINUING TO COLLECT DATA ON ALL THE INCIDENCE CASES OF CANCER IN THE STATE OF MARYLAND. THE COLLECTED DATA WILL BE USED TO MONITOR TRENDS AND PATTERNS IN CANCER INCIDENCE, GUIDE THE PLANNING AND EVALUATION OF CANCER CONTROL PROGRAMS, HELP SET PRIORITIES FOR ALLOCATING PUBLIC HEALTH AND HEALTH CARE RESOURCES, ASSESS CANCER CLUSTER CONCERNS, PROVIDE INFORMATION FOR A NATIONAL DATABASE OF CANCER INCIDENCE, AND EXCHANGE CANCER DATA WITH OTHER STATES TO ASSURE MORE COMPLETE AND ACCURATE INCIDENCE DATA., G3017251748, G303313990, G3050894790, G3053356571, G3055332318, G3081475250, G3104973458, G3117572991, G3141755360, G3170692436, G3174604425, G3233272192, G3250021483, G327625407, G3320100446, G3328679326, G3329007658, G3376064638, G3399131841, G3406693879, G3446711264, G3451414727, G348785930, G349106398, G3502709245, G3524644875, G3535040709, G3536079328, G3543523425, G3554404301, G355846211, G3559681879, G356778428, G3575964969, G3576958170, G3595805685, G3599498665, G3603768896, G3612474729, G3634973412, G3637291421, G365332712, G3668259588, G367618303, G3693590737, G3729156826, G374327972, G3776913714, G3827278403, Infrastructure Support and Pilot Tissue Collection for the CARET Biorepository, G3835960875, G3849299568, G3867322533, G3907020679, G3964026636, Dietary and Hormonal Determinants of Cancer in Women, G3974050116, G3974691180, G4032711583, G4042319840, G4079049029, G4098851317, G412175284, Central Sweden Cohorts & Biobank, G4155712275, G4180707321, G4211387915, G422445311, G4224896698, G4233509591, G423933611, G4245875310, G4289084031, G4300968980, G4303672817, G4306657466, G4346707325, G4355771977, G4378152838, G4409035895, G4409790911, G4409899835, G4417655372, G4423665262, G4448961366, G4462160033, G4466429303, G4499735890, G4606329139, G462508276, G4673757132, G4703060718, G4744497467, G4818447262, G4844208673, G4857061935, G4858979163, G4880817782, G4881195352, G4902673736, G4923733781, G4930083931, G493358262, The EPIC-Norfolk prospective population study: biological and behavioural determinants of health and disease in an ageing population, G4963598836, G4968824801, G4973042092, G5003683566, CLUE STUDIES--EVALUATING BIOMARKERS OF CARCINOGENESIS, G5022126364, G5026748561, G5054096146, G5058997197, G5069802979, G5078184151, G5089327060, G5090410713, G5134021606, G5137858745, G5181870115, G5194689995, G5197845165, G5206790748, G5259089724, G5268588722, G5272917877, G527520901, G5294110089, G5300295481, G5304242060, G5315906942, G5343409947, Shanghai Men's Health Study, G5363848375, G5400679422, G5463134625, G5469230434, G5472697759, G547275475, Etude Epidémiologique des Enfants de femmes de l'Education Nationale, G554960330, G5579042124, G5592572481, G5600012445, G5618201019, G5662660744, G5748618488, G575664126, G5768527752, G5776202406, G5777902738, G5800547038, G5846834214, G5885537923, G5900027792, G5910084128, G6011292573, INFRASRUCTURE SUPPORT AND DATA ENHANCEMENTS FOR THE CARET BIOREPOSITORY, G6025337639, G602992300, G6035964259, G6069138282, G6080346254, G6089501056, G6090438606, G6132700753, G6144205333, G6145528938, G6147499578, G6153405184, G6156155776, G6177794165, G6191607766, G6200764915, G6221897439, G6274749655, G6280939957, G6286796785, G6296150788, G6324679927, G6335278689, G6365175146, G6374953548, G6376359690, G6457415773, G6467946556, G6473583094, G6481444293, G6481893073, G6487494159, G6495963140, G6504161703, G6555706083, G6566148188, G6576231041, G6596324812, G662524821, G6626718469, G6631754812, G6656156659, G666954435, G6672458653, G6682251940, G6688108200, Epidemiology of Chronic Disease, Health Interventions and DNA Studies, G6719391877, G6727411954, G6729153333, G6739022024, G6740240955, G674394642, G6768335364, G6780254327, G6793143258, G6835760186, G6842050012, G6848493935, G6852031360, G6854088493, G6862795761, G6883270616, G6894818919, G6896564351, G6957242214, G6962570488, G6964821314, G7018858328, G7027388551, G7042089715, G707346186, G7112453972, G7133737134, Epidemiology of Cancer in a Cohort of Older Women, G7159829730, G7165037524, G7165850137, G7180840450, G7187368266, G7199237069, GENE-ENVIRONMENT INTERACTIONS: THE ODYSSEY COHORT, G7211223747, G722388296, G7256918494, G7277008482, G7284104723, Precision Public Health for major cancers - 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