Article open access publication

Pre-diagnostic meat and fibre intakes in relation to colorectal cancer survival in the European Prospective Investigation into Cancer and Nutrition

British Journal Of Nutrition, Cambridge University Press (CUP), ISSN 0007-1145

Volume 116, 2, 2016

DOI:10.1017/s0007114516001859, Dimensions: pub.1029118458, PMC: PMC5570524, PMID: 27193442,



  1. (1) Imperial College London, grid.7445.2
  2. (2) Aarhus University, grid.7048.b, AU
  3. (3) Department of Gastroenterology and Hepatology, University Medical Center, PO 85500, 3508, GA, Utrecht, The Netherlands
  4. (4) University of Malaya, grid.10347.31
  5. (5) National Institute for Public Health and the Environment, grid.31147.30
  6. (6) International Agency For Research On Cancer, grid.17703.32
  7. (7) Emory University, grid.189967.8
  8. (8) Division of Human Nutrition (Bode 62), PO Box 8129, 6700 EV Wageningen, The Netherlands
  9. (9) The Arctic University of Norway, grid.10919.30
  10. (10) Hospital Universitario Son Espases, grid.411164.7
  11. (11) Institute of Health Carlos III, grid.413448.e
  12. (12) Danish Cancer Society, grid.417390.8
  13. (13) Délégation Paris 11, grid.457369.a
  14. (14) Institut Gustave Roussy, grid.14925.3b
  15. (15) University of Paris-Sud, grid.5842.b
  16. (16) German Cancer Research Center, grid.7497.d
  17. (17) German Institute of Human Nutrition, grid.418213.d
  18. (18) Hellenic Health Foundation, grid.424637.0
  19. (19) National and Kapodistrian University of Athens, grid.5216.0
  20. (20) Harvard University, grid.38142.3c
  21. (21) ISPO – Cancer Research and Prevention Institute, Clinical and Descriptive Epidemiology Unit, Via delle Oblate 2, 50141, Florence, Italy
  22. (22) Fondazione IRCCS Istituto Nazionale dei Tumori, grid.417893.0
  23. (23) Cancer Registry and Histopathology Unit, ‘Civic-M.P.Arezzo’ Hospital, ASP, Via Dante No. 109, Ragusa 97100, Italy
  24. (24) Human Genetics Foundation, grid.428948.b
  25. (25) University of Naples Federico II, grid.4691.a
  26. (26) University Medical Center Utrecht, grid.7692.a
  27. (27) Cancer Registry of Norway, grid.418941.1
  28. (28) Folkhälsans Forskningscentrum, grid.428673.c
  29. (29) Karolinska Institute, grid.4714.6
  30. (30) Catalan Institute of Oncology, grid.418701.b
  31. (31) Public Health Directorate, Asturias, Ciriaco Miguel Vigil St 9, Oviedo 33006, Spain
  32. (32) Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Hospitales Universitarios de Granada/Universidad de Granada, Cuesta del Observatorio, 4, Campus Universitario de Cartuja, Granada 18080, Spain
  33. (33) Basque Regional Health Department, Public Health Direction and Biodonostia Research Institute – CIBERESP, Avenida de Navarra, 4, 20013 Donostia-San Sebastián, Spain
  34. (34) Instituto Murciano de Investigación Biosanitaria, grid.452553.0
  35. (35) Navarra Institute for Health Research, Recinto de Complejo Hospitalario de Navarra c/Irunlarrea 3, Pamplona 31008, Spain
  36. (36) Navarra Public Health Institute, c/Leyre 15, Pamplona 31003, Spain
  37. (37) Lund University, grid.4514.4
  38. (38) Umeå University, grid.12650.30
  39. (39) University of Oxford, grid.4991.5
  40. (40) University of Cambridge, grid.5335.0
  41. (41) Institute of Metabolic Science, grid.470900.a


Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (P for heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.


Research Categories

Main Subject Area

Fields of Research

Sustainable Development Goals

Links & Metrics

NORA University Profiles

Aarhus University

Dimensions Citation Indicators

Times Cited: 14

Field Citation Ratio (FCR): 4.13

Relative Citation ratio (RCR): 0.96

Open Access Info