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2015年10月26日，世界卫生组织下属国际癌症研究机构发表报告称，根据全面审阅科学文献，10个国家22位专家组成的工作小组将食用红肉（猪、牛、羊、马、鹿、兔、狗等哺乳动物的肌肉）归为“对人类致癌可能性较高”级别（2A类），该结论根据“有限证据”证明食用红肉对人类可引起癌症，并有“强有力的机理证据”支持其致癌作用；加工肉制品（热狗或熏肉肠、火腿、香肠、咸牛肉、干肉片或牛肉干、肉类罐头、肉类配料及调味汁等经过盐渍、风干、发酵、熏制或其他为增加口味或改善保存而处理过的肉类）被归为“人类致癌物”（1类），该结论根据“足够证据”证明食用加工肉制品可引发人类结直肠癌。不过，小样本队列回顾观察研究对于食用肉类是否增加乳腺癌发生风险的结论不一。 2019年8月6日，国际抗癌联盟《国际癌症杂志》在线发表美国哥伦比亚大学、国家环境卫生科学研究所、国家癌症研究所、新加坡国立大学的研究报告，调查了不同肉类和肉类诱变剂摄入量、烹饪方法与乳腺浸润癌发生风险之间的相关性。 该大样本流行病学全国队列前瞻研究的肉类摄入量和肉类烹饪习惯数据，来自4万2012例美国各州和波多黎各自由邦无乳腺癌女性（其姐妹均有乳腺癌史）2003～2009年参加姐妹研究时完成的1998年版布洛克食物频率问卷。通过多因素比例比例风险回归模型，对其他影响因素（例如年龄、种族、家庭收入、学历、月经、体重指数、腰臀比、总能量摄入量、蔬菜摄入量、水果摄入量、脂肪摄入量、乳制品摄入量、乳腺癌亲属数量、生育史、哺乳史、激素治疗史、避孕用药史、饮酒史、吸烟史、运动量）进行校正后，计算不同肉类和肉类诱变剂摄入量、烹饪方法与乳腺浸润癌发生风险之间的相关性。 结果，平均随访7.6年期间，参加姐妹研究至少1年后确诊乳腺浸润癌1536例。
根据红肉和禽肉总摄入量保持不变的替代模型分析，如果用禽肉替代红肉，那么摄入量最高与最低四分之一女性相比，乳腺浸润癌发生风险低28%（风险比：0.72，95%置信区间：0.58～0.89，趋势分析P=0.002）。 未见烹饪方法、来自红肉的杂环胺或血红素铁等可能诱变剂摄入量与乳腺浸润癌发生风险之间存在显著相关性。 因此，该研究结果表明，红肉摄入量可能增加乳腺浸润癌发生风险，禽肉摄入量可能减少乳腺浸润癌发生风险，如果用禽肉替代红肉可能减少乳腺浸润癌发生风险。 Int J Cancer. 2019 Aug 6. [Epub ahead of print] Association between meat consumption and risk of breast cancer: Findings from the Sister Study. Lo JJ, Park YM, Sinha R, Sandler DP. Columbia Mailman School of Public Health, New York, NY; National University of Singapore, Singapore; National Institute of Environmental Health Sciences, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD. What's new? Meat consumption and certain meat cooking practices may increase breast cancer risk. Few epidemiological studies, however, have examined associations between breast cancer risk and different meat types, cooking practices, and meat mutagens. In this U.S.- and Puerto Rico-based prospective cohort study, these factors were examined in relation to invasive breast cancer risk, taking into account menopausal and estrogen receptor status. Increased red meat consumption was associated with increased risk of invasive breast cancer risk, whereas poultry consumption was associated with decreased risk. Breast cancer risk was unrelated to cooking practices, levels of potentially mutagenic heterocyclic amines, or heme iron. Meat consumption has been postulated to increase the risk of breast cancer, but this association has not been consistently seen. We examined the association between consumption of different types of meat, meat mutagens and incident invasive breast cancer. Information on consumption of different meat categories and meat cooking practice behaviors was obtained from 42,012 Sister Study participants who completed a Block 1998 Food Frequency Questionnaire at enrollment (2003-2009) and satisfied eligibility criteria. Exposure to meat type and meat mutagens was calculated, and associations with invasive breast cancer risk were estimated using multivariable Cox proportional hazards regression. During follow-up (mean, 7.6 years), 1,536 invasive breast cancers were diagnosed at least 1 year after enrollment. Increasing consumption of red meat was associated with increased risk of invasive breast cancer (HRhighest vs. lowest quartile:1.23, 95% CI: 1.02-1.48, ptrend = 0.01). Conversely, increasing consumption of poultry was associated with decreased invasive breast cancer risk (HR highest vs. lowest quartile: 0.85; 95% CI: 0.72-1.00; ptrend = 0.03). In a substitution model with combined red meat and poultry consumption held constant, substituting poultry for red meat was associated with decreased invasive breast cancer risk (HR highest vs. lowest quartile of poultry consumption: 0.72, 95% CI: 0.58-0.89). No associations were observed for cooking practices, estimated heterocyclic amines or heme iron from red meat consumption with breast cancer risk. Red meat consumption may increase the risk of invasive breast cancer, whereas poultry consumption may be associated with reduced risk. Substituting poultry for red meat could reduce breast cancer risk. KEYWORDS: red meat; poultry; breast cancer DOI: 10.1002/ijc.32547
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