European Journal of Epidemiology

, Volume 32, Issue 5, pp 409–418 | Cite as

Associations of red and processed meat intake with major molecular pathological features of colorectal cancer

  • Prudence R. Carr
  • Lina Jansen
  • Stefanie Bienert
  • Wilfried Roth
  • Esther Herpel
  • Matthias Kloor
  • Hendrik Bläker
  • Jenny Chang-Claude
  • Hermann Brenner
  • Michael Hoffmeister


Red and processed meat is an established risk factor for colorectal cancer (CRC). However, exact mechanisms to explain the associations remain unclear. Few studies have investigated the association with CRC by molecular tumor features, which could provide relevant information on associated molecular pathways. In this population-based case–control study from Germany (DACHS), 2449 cases and 2479 controls provided information on risk factors of CRC and completed a food frequency questionnaire. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) for the associations between meat intake and risk of CRC by molecular pathologic features and specific subtypes. Red and processed meat intake was associated with increased risk of colorectal (>1 time/day vs ≤1 time/week OR 1.66, 95% CI 1.34–2.07), colon and rectal cancer. Among the single molecular tumor features investigated, the results were similar for associations of red and processed meat with CRC risk by microsatellite instability, CpG island methylator phenotype, BRAF, oestrogen receptor-β and p53 status. Red and processed meat intake was associated less strongly with risk of KRAS-mutated CRC (OR >1 time/day vs ≤1 time/week: 1.49, 95% CI 1.09–2.03) than with risk of KRAS-wildtype CRC (OR 1.82, 95% CI 1.42–2.34; p heterogeneity 0.04). These results support an association between red and processed meat and CRC risk similar for subsites of CRC and most of the investigated major molecular pathological features. Potential differences were observed in more specific subtype analyses. Further large studies are needed to confirm these results and to help further elucidate potential underlying mechanisms.


Colorectal cancer Red meat Processed meat Molecular pathology Microsatellite instability CpG island methylator phenotype 



The authors thank Ute Handte-Daub, Ansgar Brandhorst and Petra Bächer for their excellent technical assistance. The authors thank the study participants and the interviewers who collected the data. The authors also thank the following hospitals and cooperating institutions that recruited patients for this study: Chirurgische Universitätsklinik Heidelberg, Klinik am Gesundbrunnen Heilbronn, St. Vincentiuskrankenhaus Speyer, St. Josefskrankenhaus Heidelberg, Chirurgische Universitätsklinik Mannheim, Diakonissenkrankenhaus Speyer, Krankenhaus Salem Heidelberg, Kreiskrankenhaus Schwetzingen, St. Marienkrankenhaus Ludwigshafen, Klinikum Ludwigshafen, Stadtklinik Frankenthal, Diakoniekrankenhaus Mannheim, Kreiskrankenhaus Sinsheim, Klinikum am Plattenwald Bad Friedrichshall, Kreiskrankenhaus Weinheim, Kreiskrankenhaus Eberbach, Kreiskrankenhaus Buchen, Kreiskrankenhaus Mosbach, Enddarmzentrum Mannheim, Kreiskrankenhaus Brackenheim, and Cancer Registry of Rhineland-Palatinate, Mainz. We are also very grateful for the support of the pathologies in the provision of tumour samples: Institut für Pathologie, Universitätsklinik Heidelberg; Institut für Pathologie, Klinikum Heilbronn; Institut für Angewandte Pathologie, Speyer; Pathologisches Institut, Universitätsklinikum Mannheim; Institut für Pathologie, Klinikum Ludwigshafen; Institut für Pathologie, Klinikum Stuttgart; Institut für Pathologie, Klinikum Ludwigsburg. Special thanks to the tissue bank of National Center for Tumor Diseases (NCT), Heidelberg, for storage and processing of the tissue samples.


This work was supported by the German Research Council (BR 1704/6-1, BR 1704/6-3, BR 1704/6-4, CH 117/1-1, HO 5117/2-1, HE 5998/2-1, KL 2354/3-1, RO 2270/8-1 and BR 1704/17-1), the German Federal Ministry of Education and Research (01KH0404, 01ER0814, 01ER0815, 01ER1505A and 01ER1505B), and the Interdisciplinary Research Program of the National Center for Tumor Diseases (NCT), Germany.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10654_2017_275_MOESM1_ESM.docx (85 kb)
Supplementary material 1 (DOCX 84 kb)


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Prudence R. Carr
    • 1
  • Lina Jansen
    • 1
  • Stefanie Bienert
    • 1
  • Wilfried Roth
    • 2
    • 3
  • Esther Herpel
    • 3
    • 4
  • Matthias Kloor
    • 5
  • Hendrik Bläker
    • 6
  • Jenny Chang-Claude
    • 7
    • 8
  • Hermann Brenner
    • 1
    • 9
    • 10
  • Michael Hoffmeister
    • 1
  1. 1.Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany
  2. 2.Institute of PathologyUniversity Medical Center MainzMainzGermany
  3. 3.Institute of PathologyHeidelberg University HospitalHeidelbergGermany
  4. 4.NCT Tissue BankNational Center for Tumor Diseases (NCT)HeidelbergGermany
  5. 5.Department of Applied Tumor Biology, Institute of PathologyHeidelberg University HospitalHeidelbergGermany
  6. 6.Institute of PathologyCharité University MedicineBerlinGermany
  7. 7.Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
  8. 8.Genetic Tumour Epidemiology GroupUniversity Medical Center Hamburg-Eppendorf, University Cancer Center HamburgHamburgGermany
  9. 9.Division of Preventive OncologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
  10. 10.German Cancer Consortium (DKTK)German Cancer Research Center (DKFZ)HeidelbergGermany

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