Table 3. Pooled hazard ratio of colorectal cancer subsites according to 1-serving-per-day increase of red meat intake by cancer subsites and time of exposure a .
| Baseline | Simple update (0-4-year lag) | 4-8-year lag | 8-12-year lag | 12-16-year lag | Cumulativeaverage | |
|---|---|---|---|---|---|---|
| Proximal colon cancer | ||||||
| Cases | 1,151 | 1,007 | 898 | 784 | 647 | 1,151 |
| Total red meat | ||||||
| Age-adjusted HR (95% CI) | 1.11 (1.02–1.20) | 1.10 (0.99–1.23) | 1.12 (0.99–1.25) | 1.06 (0.90–1.26) | 1.09 (0.87–1.37) | 1.15 (1.04–1.28) |
| P for trend | 0.01 | 0.07 | 0.06 | 0.46 | 0.43 | 0.009 |
| Multivariable-adjusted HR (95% CI) | 1.05 (0.96–1.16) | 1.00 (0.88–1.14) | 1.09 (1.00–1.19) | 1.02 (0.90–1.16) | 1.04 (0.88–1.22) | 1.06 (0.92–1.22) |
| P for trend | 0.27 | 0.95 | 0.06 | 0.74 | 0.68 | 0.44 |
| Unprocessed red meat | ||||||
| Age-adjusted HR (95% CI) | 1.18 (1.04–1.35) | 1.19 (1.01–1.40) | 1.18 (0.99–1.41) | 1.13 (0.83–1.54) | 1.11 (0.88–1.39) | 1.25 (1.06–1.47) |
| P for trend | 0.01 | 0.04 | 0.06 | 0.43 | 0.38 | 0.008 |
| Multivariable-adjusted HR (95% CI) | 1.13 (0.99–1.29) | 1.07 (0.89–1.29) | 1.14 (1.00–1.30) | 1.08 (0.88–1.31) | 1.03 (0.89–1.20) | 1.14 (0.92–1.40) |
| P for trend | 0.07 | 0.48 | 0.05 | 0.47 | 0.66 | 0.22 |
| Processed red meat | ||||||
| Age-adjusted HR (95% CI) | 1.08 (0.94–1.24) | 1.11 (0.91–1.34) | 1.16 (0.94–1.43) | 1.07 (0.83–1.37) | 1.13 (0.77–1.65) | 1.17 (0.97–1.41) |
| P for trend | 0.27 | 0.30 | 0.18 | 0.59 | 0.55 | 0.11 |
| Multivariable-adjusted HR (95% CI) | 0.98 (0.84–1.15) | 0.95 (0.76–1.18) | 1.10 (0.94–1.29) | 1.00 (0.83–1.20) | 1.04 (0.78–1.40) | 0.99 (0.79–1.24) |
| P for trend | 0.82 | 0.62 | 0.23 | 0.97 | 0.78 | 0.93 |
| Distal colon cancer | ||||||
| Cases | 817 | 696 | 594 | 473 | 382 | 817 |
| Total red meat | ||||||
| Age-adjusted HR (95% CI) | 1.11 (1.01–1.21) | 1.10 (0.97–1.24) | 1.12 (0.98–1.29) | 1.20 (1.03–1.40) | 1.17 (0.86–1.59) | 1.15 (1.02–1.30) |
| P for trend | 0.04 | 0.14 | 0.09 | 0.02 | 0.32 | 0.02 |
| Multivariable-adjusted HR (95% CI) | 1.04 (0.93–1.16) | 0.95 (0.82–1.11) | 1.10 (0.99–1.22) | 1.14 (1.02–1.28) | 1.14 (0.93–1.39) | 1.01 (0.86–1.19) |
| P for trend | 0.52 | 0.51 | 0.08 | 0.03 | 0.21 | 0.86 |
| Unprocessed red meat | ||||||
| Age-adjusted HR (95% CI) | 1.00 (0.86–1.15) | 1.02 (0.84–1.24) | 1.02 (0.82–1.27) | 1.10 (0.86–1.40) | 1.04 (0.58–1.85) | 0.99 (0.81–1.20) |
| P for trend | 0.97 | 0.84 | 0.86 | 0.46 | 0.91 | 0.88 |
| Multivariable-adjusted HR (95% CI) | 0.88 (0.75–1.05) | 0.82 (0.66–1.03) | 0.97 (0.82–1.15) | 1.00 (0.84–1.21) | 0.97 (0.67–1.41) | 0.75 (0.68–0.82) |
| P for trend | 0.16 | 0.10 | 0.75 | 0.94 | 0.88 | <0.001 |
| Processed red meat | ||||||
| Age-adjusted HR (95% CI) | 1.31 (1.14–1.51) | 1.28 (1.04–1.56) | 1.35 (1.09–1.68) | 1.50 (1.20–1.89) | 1.46 (1.12–1.90) | 1.50 (1.25–1.80) |
| P for trend | <0.001 | 0.02 | 0.006 | <0.001 | 0.005 | <0.001 |
| Multivariable-adjusted HR (95% CI) | 1.23 (1.05–1.44) | 1.09 (0.86–1.38) | 1.31 (1.12–1.54) | 1.43 (1.20–1.70) | 1.42 (1.16–1.74) | 1.36 (1.09–1.69) |
| P for trend | 0.009 | 0.48 | 0.001 | <0.001 | <0.001 | 0.006 |
| Rectal cancer | ||||||
| Cases | 589 | 509 | 441 | 362 | 306 | 589 |
| Total red meat | ||||||
| Age-adjusted HR (95% CI) | 1.08 (0.96–1.21) | 1.17 (1.01–1.35) | 1.19 (1.02–1.38) | 1.21 (1.02–1.44) | 1.13 (0.93–1.38) | 1.19 (1.03–1.37) |
| P for trend | 0.20 | 0.03 | 0.03 | 0.03 | 0.23 | 0.02 |
| Multivariable-adjusted HR (95% CI) | 1.04 (0.90–1.20) | 1.14 (0.96–1.35) | 1.19 (1.06–1.34) | 1.20 (1.05–1.37) | 1.11 (0.93–1.31) | 1.14 (0.94–1.37) |
| P for trend | 0.57 | 0.13 | 0.003 | 0.008 | 0.25 | 0.18 |
| Unprocessed red meat | ||||||
| Age-adjusted HR (95% CI) | 1.08 (0.91–1.28) | 1.24 (0.96–1.61) | 1.27 (1.01–1.59) | 1.24 (0.95–1.61) | 1.11 (0.83–1.48) | 1.21 (0.97–1.52) |
| P for trend | 0.38 | 0.10 | 0.04 | 0.12 | 0.49 | 0.09 |
| Multivariable-adjusted HR (95% CI) | 1.05 (0.84–1.32) | 1.22 (0.95–1.58) | 1.29 (1.08–1.53) | 1.22 (1.00–1.49) | 1.07 (0.86–1.34) | 1.14 (0.86–1.51) |
| P for trend | 0.66 | 0.12 | 0.005 | 0.05 | 0.52 | 0.37 |
| Processed red meat | ||||||
| Age-adjusted HR (95% CI) | 1.13 (0.93–1.36) | 1.24 (0.97–1.58) | 1.27 (0.98–1.65) | 1.35 (0.89–2.05) | 1.24 (0.83–1.85) | 1.33 (1.04–1.70) |
| P for trend | 0.22 | 0.09 | 0.08 | 0.16 | 0.29 | 0.02 |
| Multivariable-adjusted HR (95% CI) | 1.05 (0.85–1.30) | 1.14 (0.86–1.50) | 1.25 (1.03–1.53) | 1.31 (0.94–1.83) | 1.19 (0.88–1.63) | 1.18 (0.89–1.57) |
| P for trend | 0.64 | 0.35 | 0.03 | 0.10 | 0.26 | 0.25 |
a Each multivariable model adjusted for age, 2-year follow-up cycle, family history of colorectal cancer, prior lower gastrointestinal endoscopy, pack-years of smoking before age 30 (0, 0–4, 4–10, >10), body mass index (in kg/m2; <22, 22–24, 24–25, 25–27, 27–29, 29–30, 30–32, 32–35, 35–40, or ≥40), physical activity (in metabolic equivalent-hours/week; <3, 3–9, 9–18, 18–27, or ≥27), current multivitamin use, postmenopausal status and hormone use in women (premenopausal, and never, past and current users of postmenopausal hormone), regular aspirin or NSAID use (≥2 tablets/week), total caloric intake (quintiles), alcohol consumption (in g/d; <5, 5–10, 10–15, 15–30, or ≥30), and energy-adjusted intake of folate (quintiles), calcium (quintiles), vitamin D (quintiles) and total fiber. (quintiles). Continuous measures of red meat intake generated the P-for-trend across categories and were used to estimate the HRs and 95% CIs for a 1-serving-per-day increase in intake.