Red meat, poultry, and fish consumption and the risk of liver cancer: a prospective cohort study of 0.5 million Chinese adults

Abstract Background: Epidemiological evidence on meat consumption and liver cancer risk is limited and inconclusive; moreover, no prospective study has been conducted to investigate this association in China. Hence, we performed this study to examine the associations of red meat, poultry, and fish consumption with the risk of liver cancer in a Chinese population. Methods: A total of 510,048 Chinese adults aged 30–79 years were included, and were followed up through December 31, 2016. Red meat, poultry, and fish consumption were evaluated using an interviewer-administered laptop-based questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) for liver cancer incidence were calculated using Cox regression. Results: Over a mean follow-up of 9.94 years, 1906 liver cancer cases were observed. Each 50 g/day increase in red meat (HR 0.72, 95% CI 0.49–1.05), poultry (HR 0.93, 95% CI 0.83–1.03), and fish (HR 0.95; 95% CI 0.85–1.05) consumption was not associated with the risk of liver cancer in the whole study population; however, subgroup analysis revealed an inverse association with poultry consumption in rural residents but not in urban residents (Pinteraction=0.046). The initial associations did not change materially in a series of sensitivity analyses. Conclusions: Red meat and fish consumption are not associated with the risk of liver cancer in this Chinese population. The inverse association with poultry consumption in Chinese rural residents should be interpreted with caution. Impact: This is the first prospective study examining the association between meat consumption and the risk of liver cancer in the Chinese population.