Milk and Dairy Consumption and Risk of Bladder Cancer: A Meta-analysis

doi:10.1016/j.urology.2011.09.002

Urology

Volume 78, Issue 6, December 2011, Pages 1298-1305

https://doi.org/10.1016/j.urology.2011.09.002 Get rights and content

Objective

To explore potential relations between the intake of milk or dairy products and the risk of bladder cancer.

Methods

Eligible studies published up to May 2011 were retrieved via both computer searches and manual review of references. Random-effects models were used to calculate summary relative risk estimates (SRRE) based on high-contrast to low-intake values. Sensitivity and influence analyses were conducted, and heterogeneity among study results was explored through stratified analyses by study design, gender, geographic region, year of publication, or whether or not adjustment for several confounders (ie, age, gender, body mass index, smoking, and total energy intake).

Results

We extracted data from 14 studies on milk (involving 4879 cases) and 6 studies on dairy products (3087 cases). The total study population was up to 324,241 individuals. Overall, there was no significant association between milk intake and bladder cancer (SRRE 0.89, 95% CI 0.77-1.02). However, an inverse association was found in the United States (SRRE 0.88, 95% CI .79-.99). In addition, no significant association was observed between consumption of dairy products and risk of bladder cancer (SRRE 0.95, 95% CI .71-1.27), though an inverse association was detected in the Japanese population (SRRE 0.56, 95% CI .40-.80).

Conclusion

There appears to be enough evidence to support the null hypothesis. The overall result was not statistically significant. The findings of this meta-analysis are not supportive of an independent relationship between the intake of milk or dairy products and the risk of bladder cancer. However, these findings are based on limited research. Further efforts should be made to confirm these findings.

Section snippets

Literature Search Strategy

We conducted a literature search in PubMed to identify the eligible studies before May 2011. The primary search included the following terms: milk, dairy, cheese, ice cream, bladder, carcinoma OR cancer OR tumor OR neoplasms, and it yielded 88 articles. The search was focused on human studies, without restriction on language. In addition, in view of the large number of bladder cancers arising in China, we have also searched the China National Knowledge Infrastructure database with the same

Results

We identified 54 articles that examined the association between milk or dairy products consumption and the risk of bladder cancer. Thirty-six articles were excluded because they did not provide sufficient information to estimate a summary OR and its 95% CIs⁹ or they did not report bladder cancer individually.¹⁰ The remaining 18 studies were included in the present meta-analysis. Their characteristics are presented in Table 1. There were 6 cohort studies11, 12, 13, 14, 15, 16 with 313,212

Comment

Milk is considered the food that contains all of the different substances known to be essential for human nutrition.²⁹ To the best of our knowledge, this was the first meta-analysis exploring the potential relationship between milk or dairy products intake and risk of bladder cancer. We pooled 6 cohort studies and 12 case-control studies with a huge sample size up to 324,241 to obtain a more stable and creditable result. However, our quantitative analysis on the published epidemiologic studies

Conclusions

Although it is commonly known that there is a great nutritional benefit from the consumption of milk and dairy products, we found no significant associations between high consumption of milk or dairy products and bladder cancer risk when analyzing published epidemiologic studies by meta-analysis, except for inverse associations found in the United States for bladder cancer risk and milk intake, and in Japan for bladder cancer risk and dairy products intake with a limited study population.

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A positive association was observed between dairy milk consumption and cancer of the bladder and urinary tract in our UK Biobank observational analysis but not in our MR analyses, consistent with previous MR studies [22,66]. Previously, findings from meta-analyses of observational studies have been inconsistent, showing either associations of milk consumption with lower risk of bladder cancer [10,11,13], no association [12,67], or milk type-dependent associations [13]. It cannot be excluded that reverse causality, or a confounding effect of kidney (dys)function, may influence the relationship between milk consumption and cancer of the bladder and urinary tract.
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In observational analyses, milk consumption was associated with higher risk of bladder and urinary tract cancer (OR 1.23, 95% CI 1.03–1.47), but not with any other cancer. This association was not confirmed in the MR analysis, and genetically predicted milk consumption showed a significant association only with lower risk of colorectal cancer (0.89, 0.81–0.98 per additional 50 g/day). In the MR analyses conducted among individual cohorts, genetically predicted milk consumption provided evidence for an association with lower colorectal cancer in the FinnGen cohort (0.85, 0.74–0.97), and in the UK Biobank greater risk of female breast cancer (1.12, 1.03–1.23), and uterine cancer in pre-menopausal females (3.98, 1.48–10.7).
In a comprehensive survey of milk-cancer associations, we confirm of a protective role of milk consumption for colorectal cancer. Our analyses also provide some suggestion for higher risks of breast cancer and premenopausal uterine cancer, warranting further investigation.
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The academic literature used
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Citation Excerpt :
Wine drinking may have a dose-dependent association with health: low doses might protect against breast cancer and CVD while high doses offer no benefit or increased risk (Chen et al., 2016; de Gaetano, Di Castelnuovo, Rotondo, Iacoviello, & Donati, 2002). Health benefits or risks specific to beer and milk are unclear (Gijsbers et al., 2016; Guo et al., 2017; Kaplan, Palmer, & Denke, 2000; Larsson, Crippa, Orsini, Wolk, & Michaelsson, 2015; Lee, Fu, Chung, Jang, & Lee, 2018; Li et al., 2011; Liu et al., 2015; Mullie, Pizot, & Autier, 2016; Soedamah-Muthu et al., 2011). There are currently no health benefits to SSB consumption but rather convincing data supporting its role in obesity which is, in turn, a risk factor for several diseases (Malik et al., 2010; Malik, Schulze, & Hu, 2006).
Beverages make important contributions to nutritional intake and their role in health has received much attention. This review focuses on the genetic determinants of common beverage consumption and how research in this field is contributing insight to what and how much we consume and why this genetic knowledge matters from a research and public health perspective. The earliest efforts in gene-beverage behavior mapping involved genetic linkage and candidate gene analysis but these approaches have been largely replaced by genome-wide association studies (GWAS). GWAS have identified biologically plausible loci underlying alcohol and coffee drinking behavior. No GWAS has identified variants specifically associated with consumption of tea, juice, soda, wine, beer, milk or any other common beverage. Thus far, GWAS highlight an important behavior-reward component (as opposed to taste) to beverage consumption which may serve as a potential barrier to dietary interventions. Loci identified have been used in Mendelian randomization and gene × beverage interaction analysis of disease but results have been mixed. This research is necessary as it informs the clinical relevance of SNP-beverage associations and thus genotype-based personalized nutrition, which is gaining interest in the commercial and public health sectors.

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: Funding Support: This study was funded by grants from the Natural Science Foundation of Guangdong Province of China (no. 9151051501000030) (W.L.T.), the University of Helsinki Medicine Fund (Y.Z.), and the University of Helsinki Jubilee Fund (Y.Z.).

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Health Outcomes ResearchMedical OncologyMilk and Dairy Consumption and Risk of Bladder Cancer: A Meta-analysis

Objective

Methods

Results

Conclusion

Section snippets

Literature Search Strategy

Results

Comment

Conclusions

Urology

J Clin Epidemiol

Am J Clin Nutr

Ann Epidemiol

Urology

Epidemiology of urinary bladder cancer: from tumor development to patient's death

World J Urol

Bladder cancer

Curr Opin Oncol

The impact of dietary and lifestyle risk factors on risk of colorectal cancer: a quantitative overview of the epidemiological evidence

Int J Cancer

Epidemiology and prevention of bladder cancer

Eur J Cancer Prev

Bias in meta-analysis detected by a simple, graphical test

BMJ

Operating characteristics of a rank correlation test for publication bias

Biometrics

Dietary risk factors in human bladder cancer

Am J Epidemiol

Foods and beverages in relation to urothelial cancer: case-control study in Japan

Int J Urol

Dairy intake and the risk of bladder cancer in the Netherlands cohort study on diet and cancer

Am J Epidemiol

Bladder-cancer incidence in relation to vegetable and fruit consumption: a prospective study of atomic-bomb survivors

Int J Cancer

Health Outcomes Research
Medical Oncology
Milk and Dairy Consumption and Risk of Bladder Cancer: A Meta-analysis