Poultry Consumption and Cancer

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Epidemiologic evidence suggests that high poultry consumption is not associated with an increased risk of most cancers, including cancer mortality.
Epidemiologic evidence suggests that high poultry consumption is not associated with an increased risk of most cancers, including cancer mortality.

Poultry, which includes chicken, turkey, and other fowl such as duck and guinea, constitutes the largest proportion of meat consumed by the US population.1 The risk of cancer incidence associated with poultry consumption — most often defined as chicken or chicken and turkey — has been evaluated in epidemiologic studies. Most studies have, however, found no association between high poultry consumption and the development of cancer, though several studies demonstrated a positive association with thyroid cancer.

Thyroid Cancer

An analysis of the NIH-AARP Diet and Health Study included 292,477 participants aged 51 to 72 years who completed a food frequency questionnaire from adolescence and mid-life.2 The median follow-up was 10 years and 325 developed thyroid cancer. Chicken and/or turkey consumption during adolescence, but not mid-life, demonstrated a significant dose-response relationship to an increased risk of thyroid cancer (P-trend < .02). The hazard ratio (HR) increased with a higher intake per day from 1.03 (95% CI, 0.66-1.60) in quartile 2 to 1.39 (95% CI, 0.91-2.12) and 1.59 (0.97-2.60) in quartiles 3 and 4 compared with quartile 1. The overall HR for high consumption of chicken and turkey during adolescence or mid-life was not significant, at 1.77 (95% CI, 0.81-3.85) and 1.12 (95% CI, 0.66-1.91), respectively.

A systematic review identified a population-based case-control study consisting of 313 cases and controls, and a cohort study — also from the NIH-AARP study — which found a significant positive association between poultry consumption and thyroid cancer.3 In the case-control study, high chicken consumption resulted in an odds ratio (OR) of 3.0 (95% CI, 1.3-6.8; P < .01) compared with no consumption. In the cohort study, which included 492,186 males with a follow-up of 9 years, high poultry consumption resulted in an HR of 1.74 (95% CI, 1.14-2.67; P = .005) compared with low consumption.

Other Cancers

Multiple meta-analyses of prospective cohort and case-control studies found no association between poultry consumption and risk of bladder, breast, colorectal, endometrial, esophageal, lung, ovarian, pancreatic, prostate, and renal cancers, and non-Hodgkin lymphoma.4-19

A pooled analysis of the Health Professionals Follow-Up Study and the Nurses' Health Study found a positive dose-response relationship between increasing levels of intake of chicken without skin, but not with skin, and the risk of bladder cancer (P = .01).5 The highest consumption level of at least 5 servings per week was associated with an increased risk of bladder cancer among men (relative risk [RR], 1.52; 95% 1.09-2.11), but not women (RR, 1.45; 95% CI, 0.96-2.17). There was no association for fewer than 5 servings per week of chicken with or without skin.

Though a meta-analysis demonstrated no association between poultry consumption and prostate cancer, one study found an increased risk of prostate cancer progression with higher levels of poultry consumption after diagnosis.16,18 In a prospective study of 1294 men with prostate cancer without evidence of progression or recurrence at enrollment, higher consumption of poultry with skin was significantly associated with progression (HR, 2.26; 95% CI, 1.36-3.76; P-trend = .03). This association was particularly evident among men with high prognostic risk compared with those with low/intermediate prognostic risk (P = .003).18

Several studies demonstrated that high poultry consumption may have a protective effect against cancer risk. A meta-analysis of 23 case-control and 11 cohort studies that was adjusted for smoking or included only never-smokers found an inverse association between poultry consumption and lung cancer (RR, 0.91; 95% CI, 0.85-0.97).12 A population-based case-control study of 532 pancreatic cancer cases and 1701 controls also demonstrated an inverse association between chicken and/or turkey consumption and pancreatic cancer (OR, 0.7; 95% CI, 0.5-1.0).15

Conclusions

Epidemiologic evidence suggests that high poultry consumption is not associated with an increased risk of most cancers, including cancer mortality.20 Several studies indicate that high poultry consumption, particularly during adolescence, may, however, increase the risk of thyroid cancer. Prostate cancer progression may also be affected by consumption of poultry with skin.

References

  1. Poultry & eggs. United States Department of Agriculture website. https://www.ers.usda.gov/topics/animal-products/poultry-eggs/. Updated November 13, 2017. Accessed January 22, 2018.
  2. Braganza MZ, Potischman N, Park Y, Thompson FE, Hollenbeck AR, Kitahara CM. Adolescent and mid-life diet and subsequent risk of thyroid cancer in the NIH-AARP Diet and Health Study. Int J Cancer. 2015;137:2413-23. doi:10.1002/ijc.29600
  3. Choi WJ, Kim J. Dietary factors and the risk of thyroid cancer: a review. Clin Nutr Res. 2014;3:75-88. doi: 10.7762/cnr.2014.3.2.75
  4. Larsson SC, Johansson JE, Andersson SO, Wolk A. Meat intake and bladder cancer risk in a Swedish prospective cohort. Cancer Causes Control. 2009;20:35-40. doi: 10.1007/s10552-008-9214-x
  5. Michaud DS, Holick CN, Giovannucci E, Stampfer MJ. Meat intake and bladder cancer risk in 2 prospective cohort studies. Am J Clin Nutr. 2006;84:1177-83.
  6. Wu J, Zeng R, Huang J, et al. Dietary protein sources and incidence of breast cancer: a dose-response meta-analysis of prospective studies. Nutrients. 2016;8:730-50. doi: 10.3390/nu8110730
  7. Carr PR, Walter V, Brenner H, Hoffmeister M. Meat subtypes and their association with colorectal cancer: Systematic review and meta-analysis. Int J Cancer. 2016;138:293-302.
  8. Shi Y, Yu PW, Zeng DZ. Dose-response meta-analysis of poultry intake and colorectal cancer incidence and mortality. Eur J Nutr. 2015;54:243-50. doi: 10.1007/s00394-014-0705-0
  9. Vieira AR, Abar L, Chan DS, et al. Foods and beverages and colorectal cancer risk: a systematic review and meta-analysis of cohort studies, an update of the evidence of the WCRF-AICR Continuous Update Project. Ann Oncol. 2017;28:1788-802. doi: 10.1093/annonc/mdx171
  10. Bandera EV, Kushi LH, Moore DF, Gifkins DM, McCullough ML. Consumption of animal foods and endometrial cancer risk: a systematic literature review and meta-analysis. Cancer Causes Control. 2007;18:967-88. doi: 10.1007/s10552-007-9038-0
  11. Jiang G, Li B, Liao X, Zhong C. Poultry and fish intake and risk of esophageal cancer: A meta-analysis of observational studies. Asia Pac J Clin Oncol. 2016;12:e82-91. doi: 10.1111/ajco.12114
  12. Yang WS, Wong MY, Vogtmann E, et al. Meat consumption and risk of lung cancer: evidence from observational studies. Ann Oncol. 2012;23:3163-70. doi: 10.1093/annonc/mds207
  13. Dong Y, Wu G. Lack of association of poultry and eggs intake with risk of non-Hodgkin lymphoma: a meta-analysis of observational studies. Eur J Cancer Care (Engl). 2017;26(5). doi: 10.1111/ecc.12546
  14. Kolahdooz F, van der Pols JC, Bain CJ, et al. Meat, fish, and ovarian cancer risk: results from 2 Australian case-control studies, a systematic review, and meta-analysis. Am J Clin Nutr. 2010;91:1752-63. doi: 10.3945/ajcn.2009.28415
  15. Chan JM, Wang F, Holly EA. Pancreatic cancer, animal protein and dietary fat in a population-based study, San Francisco Bay Area, California. Cancer Causes Control. 2007;18:1153-67.
  16. He Q, Wan ZC, Xu XB, Wu J, Xiong GL. Poultry consumption and prostate cancer risk: a meta-analysis. PeerJ. 2016;4:e1646. doi: 10.7717/peerj.1646
  17. John EM, Stern MC, Sinha R, Koo J. Meat consumption, cooking practices, meat mutagens and risk of prostate cancer. Nutr Cancer. 2011;63:525-37. doi: 10.1080/01635581.2011.539311
  18. Richman EL, Stampfer MJ, Paciorek A, Broering JM, Carroll PR, Chan JM. Intakes of meat, fish, poultry, and eggs and risk of prostate cancer progression. Am J Clin Nutr. 2010;91:712-21. doi: 10.3945/ajcn.2009.28474
  19. Lee JE, Spiegelman D, Hunter DJ, et al. Fat, protein, and meat consumption and renal cell cancer risk: a pooled analysis of 13 prospective studies. J Natl Cancer Inst. 2008;100:1695-706. doi: 10.1093/jnci/djn386
  20. Zhang Z, Chen GC, Qin ZZ, Tong X, Li DP, Qin LG. Poultry and fish consumption in relation to total cancer mortality: a meta-analysis of prospective studies. Nutr Cancer. 2017;26:1-9. doi: 10.1080/01635581.2018.1412474

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