Red and processed meat, poultry, fish and egg intakes and cause-specific and all-cause mortality among men with non-metastatic prostate cancer in a US Cohort

Background: Research on the relationship of meat, fish and egg consumption and mortality among prostate cancer survivors is limited. Methods: In the Cancer Prevention Study-II Nutrition Cohort, men diagnosed with non-metastatic prostate cancer between baseline in 1992/1993 and 2015 were followed for mortality until 2016. Analyses of pre- and post-diagnosis intakes of red and processed meat, poultry, fish, and eggs included 9,286 and 4,882 survivors, respectively. Multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. Results: A total of 4,682 and 2,768 deaths occurred during follow-up in pre- and post-diagnosis analyses, respectively. Both pre- and post-diagnosis intake of total red and processed meat were positively associated with all-cause mortality (quartile 4 vs 1: RR=1.13, 95% CI:1.03-1.25, P-trend = 0.02; RR=1.22, 95% CI:1.07-1.39, P-trend = 0.03, respectively), and both pre- and post-diagnosis poultry intake were inversely associated with all-cause mortality (quartile 4 vs 1 RR=0.90, 95% CI: 0.82-0.98, P-trend = 0.04; RR=0.84, 95% CI: 0.75-0.95, P-trend = 0.01, respectively). No associations were seen for prostate cancer-specific mortality, except that higher post-diagnosis unprocessed red meat intake was associated with lower risk. Conclusions: Higher red and processed meat, and lower poultry intakes either before or after prostate cancer diagnosis were associated with higher risk of all-cause mortality. Impact: Our findings provide additional evidence that prostate cancer survivors should follow the nutrition guidelines limiting red and processed meat consumption to improve overall survival. Additional research on the relationship of specific meat types and mortality is needed.