Background Red and processed meat, recognized carcinogens, are risk factors for colorectal neoplasia, including polyps, the precursor for colorectal cancer. The mechanism is unclear. One possible explanation is the mutagenic activity of these foods, perhaps due to generation during cooking [e.g., heterocyclic amine (HCA) intake]. Few studies have evaluated meat intake and sessile serrated lesion (SSL) risk, a recently recognized precursor, and no study has evaluated meat cooking methods and meat-derived mutagens with SSL risk. Objective We evaluated intakes of meat, meat cooking methods, and inferred meat mutagens with SSL risk and in comparison to risk of other polyps. Methods Meat, well-done meat, and inferred meat mutagen intakes were evaluated. Polytomous logistic regression models were used to estimate ORs and 95% CIs among cases (556 hyperplastic polyp, 1753 adenoma, and 208 SSL) and controls (3804) in the large colonoscopy-based, case-control study, the Tennessee Colorectal Polyp Study. Results The highest quartile intakes of red meat (OR: 2.38; 95% CI: 1.44, 3.93), processed meat (OR: 2.03; 95% CI: 1.30, 3.17), well-done red meat (OR: 2.19; 95% CI: 1.34, 3.60), and the HCA 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQX; OR: 2.48; 95% CI: 1.49, 4.16) were associated with increased risk of SSLs in comparison to the lowest quartile intake. Conclusions High intakes of red and processed meats are strongly and especially associated with SSL risk and part of the association may be due to HCA intake. Future studies should evaluate other mechanism(s) and the potential for primary prevention.
Colorectal polyps are the precursors of colorectal cancer, the second leading cause of cancer death in the United States. Red and processed meat intakes have been associated with an increased risk of conventional colorectal adenomas and are classified as carcinogens by the World Health Organization. The mechanism for the relationship between red and processed meat intakes and adenoma risk remains unclear. An explanation may be the exposure to mutagens derived from meat including heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) which are formed by cooking meats at high temperatures. Although intakes of these meats and mutagens has been associated with risks of conventional adenomas including in our study, no previous study has evaluated risk of sessile serrated polyp (SSPs). SSPs, a more recently recognized precursor lesion for microsatellite instable cancer, were strongly associated with red meat intake in our earlier study. This new study builds on that work by evaluating the associations between meat intake, meat cooking methods, and meat mutagens with risks of SSPs and compares the risks to conventional adenomas and hyperplastic polyps. The analysis is conducted in the Tennessee Colorectal Polyp Study, using polytomous logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (95% CI). Dietary information was collected by a self-administered food frequency questionnaire and telephone interview to ascertain meat intake and doneness. This information was used to estimate the intakes of meats, well-done meats, PAHs, HCAs, and mutagenic activity. Several measures of meat intake were strongly associated with risk of SSPs. Highest quartile levels of total meat intake (OR=2.04; 95% CI: 1.24-3.36, p for trend=0.002), red meat intake (OR=2.32; 95% CI: 1.37-3.91, p for trend<0.001), processed meat intake (OR=1.99, 95% CI: 1.24-3.20, p for trend=0.004), well-done red meat (OR=2.13, 95% CI: 1.28-3.55, p for trend=0.002), well-done processed meat (OR=1.60, 95% CI: 1.06-2.4, p for trend=0.03), and the HCA MeIQx (OR=2.55, 95% CI: 1.50-4.33, p for trend=0.003) were associated with statistically significantly increased risks of SSP in comparison to the lowest intake levels. Most of these associations were stronger for risk of SSP than for the other types of polyps. In particular, MeIQx intake was not associated with risk of conventional adenomas suggesting that the mechanisms by which red meat intake affects polyp risk may be different between the conventional adenoma and serrated pathways. Future studies are needed to confirm the relationship between meat and meat mutagen intake with SSP risk and to further define the mechanism(s) by which intake of these factors affects SSP risk. Citation Format: Dominique A. Mosley, Harvey J. Murff, Reid M. Ness, Walter E. Smalley, Wei Zheng, Martha J. Shrubsole. The association of meat intake, meat cooking methods, and meat-derived mutagen exposure with the risk of sessile serrated polyps [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 964.
tution in 2020 (P5.000). Applicant perception of a program was felt to be significantly impacted by social media presence in 36% (n515) of those surveyed in 2019, compared to 60% (n529) in 2020 (P5.031). Significantly more applicants felt that a residency program social media presence was an important recruitment strategy in 2020 compared to 2019 (P5.006). The virtual match increased applicant uses of social media in the application process in 80% of respondents (n538).CONCLUSION: Social media is a novel and essential tool for residency programs to showcase their culture. Our study highlights the utility of social media for resident applicant recruitment in the ever changing post-pandemic application milieu.
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