Abstract P1-09-01: Breast and prostate cancer risk associated with nitrites and nitrates from food additives: Results from the NutriNet-Santé cohort
Authors: Chazelas Eloi , Pierre Fabrice , Druesne-Pecollo Nathalie , Esseddik Younes , de Edelenyi Fabien Szabo , Agaesse Cédric , De Sa Alexandre , Lutchia Rebecca , Gigandet Stéphane , Srour Bernard , Debras Charlotte , Huybrechts Inge , Julia Chantal , Kesse-Guyot Emmanuelle , Allès Benjamin , Zelek Laurent , Galan Pilar , Hercberg Serge , Deschasaux-Tanguy Mélanie , Touvier Mathilde 
Published: March 2022

Abstract
Background Nitrates and nitrites occur naturally in water and soil and are commonly ingested from drinking water and dietary sources. They are also used as food additives in processed meats to increase shelf life and to avoid bacterial growth. These compounds could have a role in the carcinogenicity of processed meat. Objective To investigate the relationship between nitrate and nitrite intakes (distinguishing between natural food, water and food additive sources) and the risk of cancer in a large prospective cohort with detailed and up to date dietary assessment. Design Population based prospective cohort study. Setting Overall, 101,056 adults from the French NutriNet-Santé cohort study (2009-ongoing) were included. Consumption of nitrites and nitrates was evaluated using repeated 24h dietary records, linked to a comprehensive food composition database and accounting for details of commercial names/brands of industrial products. Main outcome measures Associations between nitrite and nitrate exposures and the risk of cancer (overall and by main cancer sites) were assessed by Cox hazard models adjusted for known risk factors. Results During follow-up, 3311 first incident cancer cases were diagnosed (among which 966 breast and 400 prostate cancers). Compared with non-consumers, higher consumers of nitrates from food additives had higher risk of breast cancer (HR=1.24 (1.03-1.48), P=0.02); this was more specifically observed for potassium nitrate (e252, HR=1.25 (1.04-1.50), P=0.01). Higher consumers of nitrites from food additives had higher risk of prostate cancer (HR=1.58 (1.14-2.18), P=0.008), specifically for sodium nitrite (e250, HR=1.62 (1.17-2.25), P=0.004). No significant association was observed for nitrates and nitrites from natural sources. Conclusions In this large prospective cohort, food additive nitrates were positively associated with breast cancer risk and food additive nitrites were positively associated with prostate cancer risk. While these results need confirmation in other large-scale prospective studies, they provide new insights in a context of lively debate around the ban of nitrite additives in the food industry. Study registration The NutriNet-Santé cohort is registered at clinicaltrials.gov (NCT03335644).
Citation Format: Eloi Chazelas, Fabrice Pierre, Nathalie Druesne-Pecollo, Younes Esseddik, Fabien Szabo de Edelenyi, Cédric Agaesse, Alexandre De Sa, Rebecca Lutchia, Stéphane Gigandet, Bernard Srour, Charlotte Debras, Inge Huybrechts, Chantal Julia, Emmanuelle Kesse-Guyot, Benjamin Allès, Laurent Zelek, Pilar Galan, Serge Hercberg, Mélanie Deschasaux-Tanguy, Mathilde Touvier. Breast and prostate cancer risk associated with nitrites and nitrates from food additives: Results from the NutriNet-Santé cohort [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-09-01.