Consumption of Red/Processed Meat and Colorectal Carcinoma: Possible Mechanisms Underlying the Significant Association

Crit Rev Food Sci Nutr. 2016;56(4):614-34. doi: 10.1080/10408398.2014.972498.


Epidemiology and experimental studies provide an overwhelming support of the notion that diets high in red or processed meat accompany an elevated risk of developing pre-neoplastic colorectal adenoma and frank colorectal carcinoma (CRC). The underlying mechanisms are disputed; thus several hypotheses have been proposed. A large body of reports converges, however, on haem and nitrosyl haem as major contributors to the CRC development, presumably acting through various mechanisms. Apart from a potentially higher intestinal mutagenic load among consumers on a diet rich in red/processed meat, other mechanisms involving subtle interference with colorectal stem/progenitor cell survival or maturation are likewise at play. From an overarching perspective, suggested candidate mechanisms for red/processed meat-induced CRC appear as three partly overlapping tenets: (i) increased N-nitrosation/oxidative load leading to DNA adducts and lipid peroxidation in the intestinal epithelium, (ii) proliferative stimulation of the epithelium through haem or food-derived metabolites that either act directly or subsequent to conversion, and (iii) higher inflammatory response, which may trigger a wide cascade of pro-malignant processes. In this review, we summarize and discuss major findings of the area in the context of potentially pertinent mechanisms underlying the above-mentioned association between consumption of red/processed meat and increased risk of developing CRC.

Keywords: Dietary patterns; N-nitroso compounds; fat peroxidation; haem; morphogenetic pathways; nitrosyl-haem; red/processed meat, intestinal carcinogenesis.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / etiology
  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology
  • Adenoma / etiology
  • Adenoma / genetics
  • Animals
  • Arginine / adverse effects
  • Bone Morphogenetic Proteins / metabolism
  • Colorectal Neoplasms / etiology*
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / pathology
  • Epigenesis, Genetic / physiology
  • Fatty Acids, Omega-6 / adverse effects
  • Feeding Behavior*
  • Food Handling*
  • Hedgehog Proteins / metabolism
  • Heme / adverse effects
  • Humans
  • Intestines / pathology
  • Intestines / physiopathology
  • Mutagens / adverse effects
  • Neoplastic Stem Cells / pathology
  • Nitroso Compounds / adverse effects
  • Nitroso Compounds / metabolism
  • Receptors, Notch / metabolism
  • Red Meat / adverse effects*
  • Risk Factors
  • Wnt Signaling Pathway


  • Bone Morphogenetic Proteins
  • Fatty Acids, Omega-6
  • Hedgehog Proteins
  • Mutagens
  • Nitroso Compounds
  • Receptors, Notch
  • Heme
  • Arginine