Table 4.
Hazard ratios and 95% confidence intervals for meat consumption and cancer of unknown primary risk in the Netherlands cohort study, stratified for cigarette smoking status
| Smoking status = never | Smoking status = ex | Smoking status = current | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Subcohort members (n=1517) | Cancer of Unknown Primary cases (n=249) | Subcohort members (n=1479) | Cancer of Unknown Primary cases (n=317) | Subcohort members (n=1115) | Cancer of Unknown Primary cases (n=333) | |||||||||||||||
| Person time at risk (years) | Cases | Age and sex adjusteda | Multivariable adjustedb | Person time at risk (years) | Cases | Age and sex adjusteda | Multivariable adjustedb | Person time at risk (years) | Cases | Age- and sex-adjusteda | Multivariable adjustedb | |||||||||
| n | HR | 95% CI | HR | 95% CI | n | HR | 95% CI | HR | 95% CI | n | HR | 95% CI | HR | 95% CI | p for interactionc | |||||
| Red meat (overall) | 0.273 | |||||||||||||||||||
| Q1 | 7 381 | 59 | 1 | Reference | 1 | Reference | 6 067 | 73 | 1 | Reference | 1 | Reference | 3 895 | 73 | 1 | Reference | 1 | Reference | ||
| Q2 | 6 603 | 71 | 1.39 | (0.95–2.02) | 1.39 | (0.95–2.04) | 6 476 | 84 | 1.15 | (0.81–1.63) | 1.15 | (0.81–1.65) | 4 259 | 69 | 0.88 | (0.60–1.29) | 0.84 | (0.57–1.24) | ||
| Q3 | 6 891 | 74 | 1.40 | (0.96–2.04) | 1.43 | (0.98–2.08) | 6 071 | 77 | 1.08 | (0.76–1.55) | 1.00 | (0.70-1.45) | 4 221 | 97 | 1.27 | (0.88–1.82) | 1.22 | (0.84–1.75) | ||
| Q4 | 6 403 | 45 | 0.93 | (0.61–1.42) | 0.96 | (0.62–1.48) | 6 134 | 83 | 1.18 | (0.83–1.69) | 1.01 | (0.69–1.47) | 5 011 | 94 | 1.09 | (0.76-1.57) | 1.05 | (0.72–1.53) | ||
| p for trendd | 0.74 | 0.59 | 0.67 | 0.56 | 0.11 | 0.12 | ||||||||||||||
| Continuous, 50 g per day increments | 27 278 | 249 | 1.03 | (0.88–1.20) | 1.05 | (0.89–1.23) | 24 749 | 317 | 1.03 | (0.89–1.19) | 0.95 | (0.81–1.12) | 17 477 | 333 | 1.14 | (0.97–1.34) | 1.15 | (0.97–1.36) | 0.329 | |
| Beef | 0.880 | |||||||||||||||||||
| Q1 | 6 475 | 48 | 1 | Reference | 1 | Reference | 6 205 | 70 | 1 | Reference | 1 | Reference | 4 612 | 81 | 1 | Reference | 1 | Reference | ||
| Q2 | 6 859 | 64 | 1.23 | (0.82–1.85) | 1.24 | (0.83–1.85) | 5 929 | 67 | 1.03 | (0.71–1.49) | 1.01 | (0.69–1.48) | 4 277 | 77 | 0.94 | (0.65–1.36) | 0.90 | (0.62–1.31) | ||
| Q3 | 7 221 | 70 | 1.30 | (0.87–1.94) | 1.31 | (0.88–1.95) | 6 227 | 79 | 1.09 | (0.76–1.56) | 1.08 | (0.75–1.56) | 4 487 | 82 | 0.98 | (0.68–1.40) | 0.94 | (0.65–1.36) | ||
| Q4 | 6 722 | 67 | 1.23 | (0.81–1.84) | 1.25 | (0.83–1.88) | 6 337 | 101 | 1.36 | (0.97–1.93) | 1.29 | (0.90–1.83) | 4 100 | 93 | 1.18 | (0.83–1.69) | 1.15 | (0.80–1.67) | ||
| p for trendd | 0.25 | 0.21 | 0.05 | 0.12 | 0.18 | 0.18 | ||||||||||||||
| Continuous, 50 g per day increments | 27 278 | 249 | 1.19 | (0.89–1.59) | 1.21 | (0.90–1.63) | 24 749 | 317 | 1.27 | (1.00–1.60) | 1.21 | (0.95–1.54) | 17 477 | 333 | 1.21 | (0.91–1.61) | 1.22 | (0.91–1.63) | 0.998 | |
| Pork | 0.220 | |||||||||||||||||||
| Q1 | 7 206 | 67 | 1 | Reference | 1 | Reference | 6 488 | 79 | 1 | Reference | 1 | Reference | 3 768 | 68 | 1 | Reference | 1 | Reference | ||
| Q2 | 6 850 | 71 | 1.14 | (0.79–1.64) | 1.14 | (0.79–1.65) | 6 253 | 78 | 1.06 | (0.74–1.50) | 0.98 | (0.69–1.40) | 4 205 | 101 | 1.35 | (0.93–1.94) | 1.27 | (0.88–1.84) | ||
| Q3 | 6 731 | 67 | 1.13 | (0.78–1.64) | 1.14 | (0.78–1.65) | 5 944 | 78 | 1.16 | (0.81–1.66) | 1.11 | (0.77–1.59) | 4 614 | 71 | 0.85 | (0.57–1.24) | 0.82 | (0.56–1.22) | ||
| Q4 | 6 491 | 44 | 0.77 | (0.51–1.17) | 0.78 | (0.52–1.19) | 6 064 | 82 | 1.15 | (0.81–1.64) | 0.97 | (0.67–1.41) | 4 890 | 93 | 1.17 | (0.81–1.70) | 1.10 | (0.75–1.62) | ||
| p for trendd | 0.03 | 0.04 | 0.73 | 0.63 | 0.19 | 0.24 | ||||||||||||||
| Continuous, 50 grams per day increments | 27 278 | 249 | 0.77 | (0.61– 0.97) | 0.78 | (0.61– 0.99) | 24 749 | 317 | 1.04 | (0.85– 1.27) | 0.95 | (0.76– 1.18) | 17 477 | 333 | 1.15 | 0.93– 1.43) | 1.15 | (0.91– 1.44) | 0.056 | |
| Minced meat | 0.560 | |||||||||||||||||||
| Q1 | 6 896 | 60 | 1 | Reference | 1 | Reference | 5 702 | 86 | 1 | Reference | 1 | Reference | 4 334 | 91 | 1 | Reference | 1 | Reference | ||
| Q2 | 6 329 | 60 | 1.08 | (0.73–1.60) | 1.08 | (0.74–1.60) | 6 440 | 96 | 1.06 | (0.76–1.47) | 1.01 | (0.72–1.42) | 4 336 | 83 | 0.92 | (0.65–1.31) | 0.90 | (0.63–1.29) | ||
| Q3 | 7 369 | 65 | 1.09 | (0.74–1.59) | 1.09 | (0.74–1.60) | 6 183 | 63 | 0.72 | (0.50–1.05) | 0.70 | (0.48–1.02) | 4 248 | 79 | 0.87 | (0.60–1.24) | 0.86 | (0.60–1.25) | ||
| Q4 | 6 683 | 64 | 1.17 | (0.79–1.71) | 1.19 | (0.80–1.75) | 6 423 | 72 | 0.79 | (0.55–1.12) | 0.77 | (0.54–1.10) | 4 559 | 80 | 0.82 | (0.58–1.17) | 0.86 | (0.60–1.24) | ||
| p for trendd | 0.32 | 0.29 | 0.03 | 0.02 | 0.46 | 0.61 | ||||||||||||||
| Continuous, 50 g per day increments | 27 278 | 249 | 1.25 | (0.80–1.95) | 1.28 | (0.82–2.01) | 24 749 | 317 | 0.64 | (0.43–0.95) | 0.62 | (0.41–0.93) | 17 477 | 333 | 0.87 | (0.59–1.27) | 0.90 | (0.62–1.33) | 0.057 | |
| Liver | 0.140 | |||||||||||||||||||
| C1 | 18 432 | 167 | 1 | Reference | 1 | Reference | 15 882 | 224 | 1 | Reference | 1 | Reference | 10 472 | 194 | 1 | Reference | 1 | Reference | ||
| C2 | 8 845 | 82 | 1.05 | (0.78–1.40) | 1.06 | (0.79–1.43) | 8 866 | 93 | 0.79 | (0.60–1.04) | 0.76 | (0.58–1.01) | 7 005 | 139 | 1.11 | (0.85–1.44) | 1.09 | (0.83–1.42) | ||
| p for trendd | 0.34 | 0.29 | 0.06 | 0.06 | 0.81 | 0.81 | ||||||||||||||
| Continuous, 25 g per day increments | 27 278 | 249 | 1.51 | (0.65–3.52) | 1.60 | (0.68–3.77) | 24 749 | 317 | 0.45 | (0.19–1.03) | 0.42 | (0.17–1.02) | 17 477 | 333 | 1.09 | (0.56–2.10) | 1.09 | (0.55–2.15) | 0.107 | |
| Poultry | 0.880 | |||||||||||||||||||
| C1 | 6 611 | 58 | 1 | Reference | 1 | Reference | 5 505 | 70 | 1 | Reference | 1 | Reference | 4 006 | 75 | 1 | Reference | 1 | Reference | ||
| C2 | 6 856 | 65 | 1.12 | (0.76–1.65) | 1.13 | (0.76–1.67) | 5 754 | 72 | 1.06 | (0.73–1.53) | 1.07 | (0.74–1.56) | 4 434 | 93 | 1.13 | (0.79–1.61) | 1.21 | (0.84–1.75) | ||
| C3 | 6 156 | 62 | 1.19 | (0.81–1.77) | 1.21 | (0.82–1.80) | 6 113 | 80 | 1.13 | (0.78–1.62) | 1.13 | (0.78–1.63) | 4 301 | 85 | 1.04 | (0.72–1.50) | 1.02 | (0.69–1.49) | ||
| C4 | 7 654 | 64 | 0.99 | (0.67–1.45) | 1.00 | (0.68–1.48) | 7 376 | 95 | 1.11 | (0.78–1.57) | 1.09 | (0.76–1.56) | 4 735 | 80 | 0.86 | (0.60–1.24) | 0.88 | (0.60–1.29) | ||
| p for trendd | 0.81 | 0.85 | 0.90 | 0.85 | 0.10 | 0.10 | 0.323 | |||||||||||||
| Continuous, 50 g per day increments | 27 278 | 249 | 0.94 | (0.58–1.52) | 0.96 | (0.59–1.54) | 24 749 | 317 | 1.03 | (0.68–1.54) | 1.04 | (0.67–1.61) | 17 477 | 333 | 0.69 | (0.44–1.07) | 0.68 | (0.43–1.07) | ||
| Processed meat | 0.239 | |||||||||||||||||||
| Q1 | 7 109 | 53 | 1 | Reference | 1 | Reference | 6 332 | 89 | 1 | Reference | 1 | Reference | 3 620 | 59 | 1 | Reference | 1 | Reference | ||
| Q2 | 6 710 | 70 | 1.49 | (1.01–2.21) | 1.52 | (1.02–2.26) | 6 661 | 66 | 0.76 | (0.54–1.09) | 0.77 | (0.54–1.10) | 4 578 | 80 | 1.15 | (0.78-1.70) | 1.12 | (0.76–1.67) | ||
| Q3 | 6 620 | 59 | 1.29 | (0.86–1.94) | 1.36 | (0.89–2.07) | 5 965 | 83 | 1.04 | (0.74–1.47) | 1.02 | (0.72–1.44) | 4 510 | 80 | 1.13 | (0.77–1.67) | 1.15 | (0.77–1.71) | ||
| Q4 | 6 838 | 67 | 1.42 | (0.95–2.11) | 1.55 | (1.00–2.39) | 5 791 | 79 | 1.09 | (0.77–1.54) | 1.06 | (0.73–1.54) | 4 769 | 114 | 1.53 | (1.06–2.22) | 1.66 | (1.12–2.46) | ||
| p for trendd | 0.10 | 0.05 | 0.19 | 0.29 | 0.35 | 0.09 | 0.722 | |||||||||||||
| Continuous, 25 g per day increments | 27 278 | 249 | 1.22 | (0.96–1.56) | 1.31 | (1.00–1.71) | 24 749 | 317 | 1.16 | (0.93–1.44) | 1.15 | (0.89–1.48) | 17 477 | 333 | 1.07 | (0.92–1.25) | 1.15 | (0.98–1.36) | ||
| Fish | 0.804 | |||||||||||||||||||
| Q1 | 9 221 | 63 | 1 | Reference | 1 | Reference | 6 087 | 67 | 1 | Reference | 1 | Reference | 4 540 | 78 | 1 | Reference | 1 | Reference | ||
| Q2 | 5 865 | 59 | 1.56 | (1.06–2.30) | 1.58 | (1.07–2.32) | 5 983 | 79 | 1.13 | (0.79–1.63) | 1.12 | (0.77–1.62) | 3 744 | 78 | 1.22 | (0.84–1.76) | 1.26 | (0.86–1.83) | ||
| Q3 | 7 860 | 80 | 1.52 | (1.06–2.18) | 1.54 | (1.07–2.22) | 8 109 | 109 | 1.22 | (0.87–1.71) | 1.14 | (0.80–1.62) | 5 076 | 97 | 1.10 | (0.78–1.56) | 1.06 | (0.74–1.53) | ||
| Q4 | 4 331 | 47 | 1.57 | (1.04–2.38) | 1.63 | (1.07–2.49) | 4 570 | 62 | 1.20 | (0.82–1.77) | 1.16 | (0.78–1.72) | 4 117 | 80 | 1.13 | (0.79–1.64) | 1.06 | (0.73–1.55) | ||
| p for trendd | 0.27 | 0.22 | 0.20 | 0.26 | 0.75 | 0.96 | ||||||||||||||
| Continuous, 25 g per day increments | 27 278 | 249 | 1.12 | (0.92–1.37) | 1.14 | (0.93–1.39) | 24 749 | 317 | 1.14 | (0.94–1.38) | 1.12 | (0.92–1.37) | 17 477 | 333 | 1.03 | (0.85–1.25) | 0.99 | (0.81–1.23) | 0.659 | |
aAnalyses were adjusted for age at baseline (years) and sex
bAnalyses were adjusted for age at baseline (years), sex, alcohol consumption, and total energy intake (kcal/day)
cInteractions were calculated with respect to smoking status in relation to the meat variable of interest and CUP risk
dTests for dose–response trends were assessed by fitting ordinal variables as continuous terms in the Cox proportional hazards model