Dietary nitrosyl-heme from processed meats and its association with colorectal cancer risk: findings from the EPIC cohort study

dc.contributor.author
Rizzolo-Brime, Lucía
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Lujan-Barroso, Leila
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Farran-Codina, Andreu
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Bou, Ricard
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Nicolas, Genevieve
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Huybrechts, Inge
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Lasheras, Cristina
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Molina Montes, Esther
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Colorado-Yohar, Sandra
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Gasque, Alba
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Dahm, Christina C.
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Bock, Niels
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Olsen, Anja
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Tjønneland, Anne
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Katzke, Verena
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le Cornet, Charlotte
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Schulze, Matthias B.
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Saieva, Calogero
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Sieri, Sabina
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De Magistris, Maria Santucci
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Tumino, Rosario
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Macciotta, Alessandra
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Wareham, Nick
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Weiderpass, Elisabete
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Chatziioannou, Chrysovalantou
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Vineis, Paolo
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Jakszyn, Paula
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Indústries Alimentàries
dc.date.accessioned
2026-02-28T23:31:28Z
dc.date.available
2026-02-28T23:31:28Z
dc.date.issued
2025-12-20
dc.identifier.issn
1475-2891
dc.identifier.uri
https://hdl.handle.net/20.500.12327/5093
dc.description.abstract
Background Processed meat (PM) consumption is an established risk factor for colorectal cancer (CRC). It has been hypothesized that nitrosyl-heme, formed by the addition of nitrites during meat processing, may enhance the carcinogenic effects of PMs. This study aims to investigate the association between nitrosyl-heme intake and CRC risk within the European Prospective Investigation into Cancer and Nutrition(EPIC) study. Methods This prospective study included 367,463 participants(70.3% women) from seven countries from the EPIC-study. Dietary data were collected via baseline questionnaires, and nitrosyl-heme exposure was estimated using biochemical data from 52 Spanish PMs, extrapolated to country-specific items. Sex-specific multivariable-adjusted hazard ratios(HRs) and 95% confidence intervals(CIs) were calculated using Cox proportional hazards models. Results Over a 15-year median follow-up, 5,115 incident CRC cases were identified. Comparing the highest vs. the lowest sex-specific tertile of nitrosyl-heme intake we found no significant association with CRC risk (HRT3vsT1:1.01;95%CI:0.93–1.09). Subgroup analyses by tumor subtype and interactions with lifestyle factors also showed no associations. Conclusions This study offers insights into nitrosyl-heme exposure in European populations but found no link to CRC risk. Further research is needed to understand nitrosyl-heme's role in CRC.
dc.description.sponsorship
This study was supported by grant from the Instituto de Salud Carlos III through the PI19/00817 project (co-funded by the European Regional Development Fund (ERDF), a way to build Europe) and through the PFIS FI20/00006 predoctoral funding (co-funded by the European Social Fund (ESF), investing in your future). The coordination of EPIC-Europe is financially supported by International Agency for Research on Cancer(IARC) and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are supported by: Danish Cancer Society (Denmark);Ligue Nationale Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale (MGEN), Institut National de la Santé et de la Recherche Médicale (INSERM), French National Research Agency (ANR, reference ANR-10-COHO-0006), French Ministry for Higher Education (subsidy 2,102,918,823, 2,103,236,497, and 2,103,586,016) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Italian Ministry of Health, Italian Ministry of University and Research (MUR), Compagnia di San Paolo (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), the National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands, for their contribution and ongoing support to the EPIC Study; the Netherlands Organisation for Health Research and Development (ZonMW), World Cancer Research Fund (WCRF), (The Netherlands); UiT The Arctic University of Norway; Health Research Fund (FIS)—Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology—ICO (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (C864/A14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), Medical Research Council (MR/N003284/1, MC-UU_12015/1 and MC_UU_00006/1 to EPIC-Norfolk; MR/Y013662/1 to EPIC-Oxford) (United Kingdom). Previous support has come from “Europe against Cancer” Programme of the European Commission (DG SANCO). We thank CERCA Programme/Generalitat de Catalunya for institutional support.
dc.format.extent
12
dc.language.iso
eng
dc.publisher
BMC
dc.relation.ispartof
Nutrition Journal
dc.rights
Attribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.uri
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.title
Dietary nitrosyl-heme from processed meats and its association with colorectal cancer risk: findings from the EPIC cohort study
dc.type
info:eu-repo/semantics/article
dc.subject.udc
663/664
dc.description.version
info:eu-repo/semantics/publishedVersion
dc.embargo.terms
cap
dc.relation.projectID
ISCIII/Programa Estatal de I+D+I orientada a los retos de la sociedad/PI19-00817/ES/Cancer colorectal y consumo de carnes procesadas. Contenido en nitrosylhemo e implicaciones en la carcinogenesis/
dc.relation.projectID
FEDER/ / /EU/ /
dc.relation.projectID
ESF/ / /EU/ /
dc.relation.projectID
SANCO/ / /EU/ /
dc.identifier.doi
https://doi.org/10.1186/s12937-025-01266-7
dc.rights.accessLevel
info:eu-repo/semantics/openAccess
dc.contributor.group
Funcionalitat i Seguretat Alimentària


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