Childhood cancer in relation to cured meat intake: Review of the epidemiological evidence

Over the past two decades a series of epidemiological studies have examined the relationship between consumption of cured meats during pregnancy and the subsequent risk of brain tumors, as well as other cancers, in the offspring. The research was prompted in large part by experimental investigations showing that transplacental exposure to certain N-nitroso compounds, i.e., nitrosoureas, could produce brain tumors in laboratory animals. Fourteen such epidemiological studies, 13 of which used the case-control approach, are reviewed here. Most of the studies showed no significant association between total cured meat intake and childhood cancer risk but more found positive than negative relationships. Furthermore, several studies reported significant positive associations for maternal and sometimes childhood or paternal consumption of one or more cured meats, with odds ratios of twofold or greater reported among the highest consumers. On the other hand a correlation analysis found no positive concordance between temporal trends from the 1970s to 1990s in childhood brain cancer rates and cured meat consumption inasmuch as cancer rates rose over time while residual nitrite levels in cured meats fell sharply. Because of the potential for bias, especially recall bias, and/or confounding, the relatively weak magnitude of the associations reported, and the inconsistency between study findings, at this time it cannot be concluded that eating cured meat has increased the risk of childhood brain cancer or any other cancers. Moreover, although N-nitroso compounds are sometimes found in cured meats or may be formed endogenously there is no empirical evidence that eating cured meats results in human neural nitrosourea exposure. Nevertheless, the hypothesis that eating nitrite-cured meats may influence childhood and perhaps adult brain cancer cannot be dismissed. Unbiased evaluation of the hypothesis may derive from the conduct of cohort studies, where the interview-derived information on cured meat intake precedes, or is nor otherwise associated with, the diagnosis of cancer.