Meat and components of meat and the risk of bladder cancer in the NIH-AARP Diet and Health Study

Cancer. 2010 Sep 15;116(18):4345-53. doi: 10.1002/cncr.25463.


Background: Meat could be involved in bladder carcinogenesis via multiple potentially carcinogenic meat-related compounds related to cooking and processing, including nitrate, nitrite, heterocyclic amines (HCAs), and polycyclic aromatic hydrocarbons (PAHs). The authors comprehensively investigated the association between meat and meat components and bladder cancer.

Methods: During 7 years of follow-up, 854 transitional cell bladder-cancer cases were identified among 300,933 men and women who had completed a validated food-frequency questionnaire in the large prospective NIH-AARP Diet and Health Study. The authors estimated intake of nitrate and nitrite from processed meat and HCAs and PAHs from cooked meat by using quantitative databases of measured values. Total dietary nitrate and nitrite were calculated based on literature values.

Results: The hazard ratios (HR) and 95% confidence intervals (CI) for red meat (HR for fifth quintile compared with first quintile, 1.22; 95% CI, 0.96-1.54; P(trend) = .07) and the HCA 2-amino-1 methyl-6-phenylimidazo(4,5-b)pyridine (PhIP) (HR, 1.19; 95% CI, 0.95-1.48; P(trend) = .06) conferred a borderline statistically significant increased risk of bladder cancer. Positive associations were observed in the top quintile for total dietary nitrite (HR, 1.28; 95% CI, 1.02-1.61; P(trend) = .06) and nitrate plus nitrite intake from processed meat (HR, 1.29; 95% CI, 1.00-1.67; P(trend) = .11).

Conclusions: These findings provided modest support for an increased risk of bladder cancer with total dietary nitrite and nitrate plus nitrite from processed meat. Results also suggested a positive association between red meat and PhIP and bladder carcinogenesis.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Carcinoma, Transitional Cell / etiology*
  • Databases as Topic
  • Diet / adverse effects*
  • Female
  • Food Handling
  • Humans
  • Male
  • Meat / adverse effects*
  • Middle Aged
  • Nitrates / adverse effects
  • Nitrites / adverse effects
  • Surveys and Questionnaires
  • Urinary Bladder Neoplasms / etiology*


  • Nitrates
  • Nitrites