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Heme Iron from Meat and Risk of Colorectal Cancer: A Meta-analysis and a Review of the Mechanisms Involved
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Abstract
Red meat and processed meat intake is associated with a risk of colorectal cancer, a major cause of death in affluent countries. Epidemiological and experimental evidence supports the hypothesis that heme iron present in meat promotes colorectal cancer. This meta-analysis of prospective cohort studies of colon cancer reporting heme intake included 566,607 individuals and 4,734 cases of colon cancer. The relative risk of colon cancer was 1.18 (95% CI: 1.06-1.32) for subjects in the highest category of heme iron intake compared with those in the lowest category. Epidemiological data thus show a suggestive association between dietary heme and risk of colon cancer. The analysis of experimental studies in rats with chemically-induced colon cancer showed that dietary hemoglobin and red meat consistently promote aberrant crypt foci, a putative precancer lesion. The mechanism is not known, but heme iron has a catalytic effect on (i) the endogenous formation of carcinogenic N-nitroso compounds and (ii) the formation of cytotoxic and genotoxic aldehydes by lipoperoxidation. A review of evidence supporting these hypotheses suggests that both pathways are involved in heme iron toxicity.
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“A high red meat intake (rich in heme iron), increases endogenous formation of N-nitroso compounds in the gastrointestinal tract that are associated with increased epithelial proliferation, oxidative stress, and iron-induced hypoxia signaling (166–168).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [167]
In the citing paper
“Potential mechanisms linking unprocessed red meat with CVD include saturated fat, cholesterol, iron, phosphatidylcholine, and carnitine; and cooking methods (e.g., barbecuing), that increase heterocyclic amine content and N-nitroso compounds, also implicated in colorectal cancer (167).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [167]
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“…markers capture complementary pathways: lipid peroxidation as indices of heme-driven oxidative injury 32,33 ; SCFAs and bile acids for microbial/epithelial homeostasis and oxidative stress/DNA damage 34–37 ; and iron/inflammatory indices relevant to red-meat exposure and carcinogenesis 8,38–40 .”
InfluentialRobinson, A. V., Vancuren, S. J., Marcone, M. F., & Allen‐Vercoe, E. (2025) · mSphere · doi:10.1128/msphere.00789-24 · Cited by 4
“It has been proposed that N -nitroso compounds resulting from heme iron and/or nitrate metabolism (7) could cause a mutagenic signature in CRC (8).”
Carcinogenicity of food additives: A review
Qadir, A. M., & Salih, D. J. (2025) · European Food Science and Engineering · doi:10.55147/efse.1607021 · Cited by 5
Woon, J. Y., Vidanapathirana, G. U., Lam, A. K.-Y., & Gopalan, V. (2025) · Journal of Gastrointestinal Cancer · doi:10.1007/s12029-025-01247-3 · Cited by 5
“This correlation also supports the hypothesized role of heme iron in CRC carcinogenesis through NOC formation and lipid peroxidation [62].”
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The Importance of Poultry Meat in Medicine: A Review
Jilo, S. A., & Hasan, L. A. (2022) · Journal of World s Poultry Research · doi:10.36380/jwpr.2022.28 · Cited by 6
Olier, M., Naud, N., Fouché, E., Tondereau, V., Ahn, I., Leconte, N., Blas-Y-Estrada, F., Garric, G., Héliès‐Toussaint, C., Harel-Oger, M., et al. (2024) · npj Science of Food · doi:10.1038/s41538-024-00273-y · Cited by 4
Shen, J., Qin, X., Zeng, X. G., Xiao, H., & Lai, S. (2024) · Medicine · doi:10.1097/md.0000000000040562 · Cited by 4
“[22,23] Iron deficiency anemia is prevalent in CRC patients, with studies indicating that female gender, right-sided colon tumors, and larger tumors are risk factors for this condition.”
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Meat and Cancer Evidence for and Against
Sødring, M. S., Oostindjer, M., Dragsted, L. O., Haug, A., Paulsen, J. E., & Egelandsdal, B. (2017) · Elsevier eBooks · doi:10.1016/b978-0-08-100593-4.00020-5 · Cited by 4
Colorectal Carcinoma and Emerging Targeted Therapies.
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Kasai, H., & Kawai, K. (2021) · Genes and Environment · doi:10.1186/s41021-021-00201-6 · Cited by 4
“In relation to red meat intake, N-nitroso compounds, such as N-nitroso-glucosylglycine, and aldehydic compounds, such as 4-hydroxy-2nonenal and malonaldehyde, generated by heme-induced lipid peroxidation, have been suggested as possible carcinogenesis mechanisms [15], but the role of AcAld has not been described so fa…”
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“MDA can react with DNA to form adducts with deoxyguanosine, deoxyadenosine and deoxycytidine (Bastide et al., 2011).”
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Analytical Tools for Assessing the Chemical Safety of Meat and Poultry
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“Based on a meta-analysis, dietary hemoglobin and red meat consistently promote aberrant crypt foci (ACF), putative pre-cancer lesions (Bastide et al., 2011).”
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Cellular Senescence Triggered by Food and Environmental Genotoxins
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Temperature of Food and Drink Intake Matters
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BackgroundRole of Food Additives and Intestinal Microflora in Colorectal Cancer
Soni, V. K., Amit, A., Chandra, V., Singh, P. K., Singh, P. K., Singh, R. P., Patel, G. K., & Singh, R. P. (2022) · Springer eBooks · doi:10.1007/978-3-030-72702-4_14 · Cited by 3
Mechanistic Hypotheses on Colorectal Cancer and Red Meat Intake: A Review
Surya, R. (2020) · IOP Conference Series Earth and Environmental Science · doi:10.1088/1755-1315/426/1/012176 · Cited by 4
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Metadata
- Authors
- Bastide, N. M., Pierre, F. H. F., & Corpet, D. E.
- Affiliations
- École Nationale Vétérinaire de Toulouse (FR)
- Corresponding author
- Pierre, Fabrice H.F.
- Venue
- Cancer Prevention Research
- Published
- 2011-02-01
- Volume
- 4
- Issue
- 2
- Pages
- 177-184
- ISSN
- 1940-6207 (ISSN-L)
- 1940-6215
- OpenAlex
- W2106489922
- Cited by
- 397
- References
- 76
- Citations by year
- 2026: 22 · 2025: 24 · 2024: 18 · 2023: 23 · 2022: 18 · 2021: 24 · 2020: 29 · 2019: 28 · 2018: 29 · 2017: 23 · 2016: 45 · 2015: 31 · 2014: 25 · 2013: 31 · 2012: 19
- FWCI
- 3.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer Prevention Research (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Funders
- Institut National de la Santé et de la Recherche Médicale
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Meat and Animal Product Quality
- Keywords
- heme iron, red meat, processed meat, colorectal cancer, colon cancer, aberrant crypt foci, N-nitroso compounds, lipid peroxidation, aldehydes, carcinogenesis mechanisms, hemoglobin
- MeSH terms
- Animals, Heme, Humans, Meat Products, Review Literature as Topic, Colorectal Neoplasms, Iron, Dietary, Rats
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