Systematic Analysis of the Differential Effects of Red Meat on Colorectal Cancer Risks: A Meta-Analytic Approach

Abstract

Objectives: Colorectal cancer (CRC) is the third most common cancer worldwide, with rising incidence in younger populations. Red meat consumption has been proposed as a risk factor for CRC, though the evidence remains inconsistent. This systematic review and meta-analysis aimed to examine the associations between the consumption of beef, pork, and lamb with CRC, colon cancer (CC), and rectal cancer (RC) risk.

Methods: The findings from 27 studies published between 1993 and 2024 were included, involving over 1 million participants from diverse geographical regions. Relative risks were calculated using random-effects meta-analysis, with subgroup and meta-regression analyses performed to assess potential sources of heterogeneity.

Results: Beef consumption was significantly associated with increased CRC risk, with a 30% overall risk increase (95% CI: 1.10-1.54). The association with colon cancer (CC) was marginally significant (RR = 1.19, 95% CI: 0.99-1.43, p = 0.0585), while the link to rectal cancer (RC) was not statistically significant. Pork consumption was associated with a 17% increased CRC risk (95% CI: 1.09-1.25), with similar, nonsignificant trends for CC and RC. Lamb consumption was weakly associated with an 11% increase in CRC risk (95% CI: 1.02-1.21), though this was based on limited studies (n = 6), and no significant associations emerged for cancer subtypes. Study design and confounding factors influenced these associations, with case-control studies reporting stronger associations than cohort studies. Physical activity adjustments were pivotal, as studies without this adjustment consistently reported higher-risk estimates.

Conclusion: These findings emphasise the importance of accounting several lifestyle factors in future research and public health guidance. While these results support current dietary guidelines recommending limited red meat consumption, they also underscore the complexity of diet-cancer relationships and the need for comprehensive, lifestyle-inclusive cancer prevention strategies.

Keywords: Beef; Colorectal cancer; Dietary risk factors; Lamb; Pork; Red meat.

Fig. 1

Flowchart of literature search and selection of studies

Fig. 2

Forest plot of relative risk of colorectal, colon, and rectal cancer with high versus low beef consumption

Fig. 3

Forest plot of cohort and case–control studies of colorectal cancer risk associated with beef consumption

Fig. 4

Forest plot of cohort and case–control studies of colon cancer risk associated with beef consumption

Fig. 5

Forest plot of cohort and case–control studies of rectal cancer risk associated with beef consumption

Fig. 6

The plot compares linear and spline models, with the size of each bubble representing the number of cases in each study

Fig. 7

Forest plot of relative risk of colorectal, colon, and rectal cancer with high versus low pork consumption

Fig. 8

Forest plot of cohort and case–control studies of colorectal cancer risk associated with pork consumption

Fig. 9

Forest plot of cohort and case–control studies of colon cancer risk associated with pork consumption

Fig. 10

Forest plot of cohort and case–control studies of rectal cancer risk associated with pork consumption

Fig. 11

The plot compares linear and spline models, with the size of each bubble representing the number of cases in each study

Fig. 12

Forest plot of relative risk of colorectal, colon, and rectal cancer with high versus low lamb consumption