# Norat et al. 2002 (Int J Cancer 98:241): red meat, cohort studies, highest vs lowest (Table I: 1.27 (1.11–1.45), n = 9) and per 120 g/day (Table II: 1.22 (1.05–1.41), n = 9)

All pooled estimates: DerSimonian–Laird random effects; weights are random-effects weights (%). Leave-one-out after each run.

## HvL – Appendix III values for the 9 cohorts named in Fig 2 (8 with CIs)

Published: 1.27 (1.11–1.45). **Pooled: 1.38 (1.16–1.64)** (fixed 1.38 (1.16–1.64); I² 0 %; k = 8). **Not reproduced.**

Thun 1992 has no CI in Appendix III; Fig 2 plots it with one. Pooling the printed values does not give the published 1.27: Norat's per-study inputs are not printed.

| Study | RR (95 % CI) | Weight % | Source / choice |
|---|---|---|---|
| willett1990 | 1.77 (1.09–2.88) | 13.2 | Appendix III: >=134 vs <59 (g/day) |
| chen1998 | 1.17 (0.68–2.02) | 10.5 | Appendix III: >1 vs <=0.5 servings/day (red meat) |
| giovannucci1994 | 1.71 (1.15–2.55) | 19.6 | Appendix III: 129.5 vs 18.5 g/day (red meat) |
| bostick1994 | 1.04 (0.62–1.76) | 11.4 | Appendix III: >11 vs <4 servings/week (red meat) |
| kato1997 | 1.23 (0.68–2.22) | 8.9 | Appendix III: Q4 vs Q1 (red meat) |
| singh1998 | 1.41 (0.90–2.21) | 15.4 | Appendix III: >=1 time/week vs never (red meat) |
| hsing1998 | 1.90 (0.90–4.30) | 5.1 | Appendix III: >=60 vs <15 times/month (red meat) |
| pietinen1999 | 1.10 (0.70–1.70) | 15.8 | Appendix III: 203 vs 79 g/day (red meat) |

Leave-one-out: without willett1990: 1.33 (1.10–1.60); without chen1998: 1.41 (1.17–1.69); without giovannucci1994: 1.31 (1.07–1.59); without bostick1994: 1.43 (1.18–1.72); without kato1997: 1.39 (1.16–1.68); without singh1998: 1.37 (1.13–1.66); without hsing1998: 1.35 (1.13–1.62); without pietinen1999: 1.44 (1.19–1.74)

## HvL – the same 8 + Thun 1992 read off Fig 2 (pixel reading by controller K11, not printed)

Published: 1.27 (1.11–1.45). **Pooled: 1.27 (1.11–1.45)** (fixed 1.27 (1.11–1.45); I² 0 %; k = 9). **Reproduced.**

With Thun's plotted entry (≈1.14, 0.93–1.39) the 9-cohort pool reproduces the published value exactly. The entry is read from figure pixels, not printed; the two sex-specific Thun values in Appendix III have no CIs.

| Study | RR (95 % CI) | Weight % | Source / choice |
|---|---|---|---|
| willett1990 | 1.77 (1.09–2.88) | 7.4 | Appendix III: >=134 vs <59 (g/day) |
| chen1998 | 1.17 (0.68–2.02) | 5.9 | Appendix III: >1 vs <=0.5 servings/day (red meat) |
| giovannucci1994 | 1.71 (1.15–2.55) | 11.1 | Appendix III: 129.5 vs 18.5 g/day (red meat) |
| bostick1994 | 1.04 (0.62–1.76) | 6.5 | Appendix III: >11 vs <4 servings/week (red meat) |
| kato1997 | 1.23 (0.68–2.22) | 5.0 | Appendix III: Q4 vs Q1 (red meat) |
| singh1998 | 1.41 (0.90–2.21) | 8.7 | Appendix III: >=1 time/week vs never (red meat) |
| hsing1998 | 1.90 (0.90–4.30) | 2.9 | Appendix III: >=60 vs <15 times/month (red meat) |
| pietinen1999 | 1.10 (0.70–1.70) | 8.9 | Appendix III: 203 vs 79 g/day (red meat) |
| thun1992 | 1.14 (0.93–1.39) | 43.5 | Fig 2 p245: single combined CPS-II entry, read from the rendered figure (low confidence) |

Leave-one-out: without willett1990: 1.24 (1.08–1.42); without chen1998: 1.28 (1.11–1.48); without giovannucci1994: 1.22 (1.06–1.41); without bostick1994: 1.29 (1.12–1.48); without kato1997: 1.28 (1.11–1.48); without singh1998: 1.26 (1.09–1.45); without hsing1998: 1.25 (1.10–1.43); without pietinen1999: 1.29 (1.12–1.48); without thun1992: 1.38 (1.16–1.64)

## HvL – the same contrasts read from the primary papers (database; Thun, Hsing not in database)

**Pooled: 1.35 (1.13–1.62)** (fixed 1.35 (1.13–1.62); I² 0 %; k = 7). 

Transcription check of Appendix III: identical to the Appendix values for all 7 cohorts we hold.

| Study | RR (95 % CI) | Weight % | Source / choice |
|---|---|---|---|
| willett1990 | 1.77 (1.09–2.88) | 13.9 | paper: red_total Q5 >=134 vs lowest (colon, Age-adjusted, energy-adjusted ) |
| chen1998 | 1.17 (0.68–2.02) | 11.1 | paper: red_total >1 serving/day vs lowest (colorectal, Conditional logistic regressio) |
| giovannucci1994 | 1.71 (1.15–2.55) | 20.7 | paper: red_total Q5 (median 129.3 g/d) vs lowest (colon, Age-adjusted (Table 2)) |
| bostick1994 | 1.04 (0.62–1.76) | 12.1 | paper: red_undefined > 11.0 vs lowest (colon, Multivariate RR (Table 3)) |
| kato1997 | 1.23 (0.68–2.22) | 9.4 | paper: red_undefined Quartile 4 vs lowest (colorectal, Table 3 (calories, age, place,) |
| singh1998 | 1.41 (0.90–2.21) | 16.3 | paper: red_undefined ≥1/week vs lowest (colon, Proportional hazards, Table 3 ) |
| pietinen1999 | 1.10 (0.70–1.70) | 16.7 | paper: red_total Q4 (median 203 g/d) vs lowest (colorectal, Multivariate RR** (Table 5)) |

Leave-one-out: without willett1990: 1.30 (1.07–1.58); without chen1998: 1.38 (1.14–1.67); without giovannucci1994: 1.27 (1.04–1.56); without bostick1994: 1.40 (1.16–1.70); without kato1997: 1.37 (1.13–1.66); without singh1998: 1.34 (1.10–1.64); without pietinen1999: 1.41 (1.16–1.72)

## HvL (Norat's 9-cohort set) – corrected: exposure

**Pooled: 1.26 (1.06–1.50)** (fixed 1.23 (1.08–1.41); I² 27 %; k = 9). 

| Study | RR (95 % CI) | Weight % | Source / choice |
|---|---|---|---|
| willett1990 | 1.77 (1.09–2.88) | 9.7 | Appendix III: >=134 vs <59 (g/day) |
| chen1998 | 1.17 (0.68–2.02) | 8.1 | Appendix III: >1 vs <=0.5 servings/day (red meat) |
| giovannucci1994 | 1.71 (1.15–2.55) | 13.0 | Appendix III: 129.5 vs 18.5 g/day (red meat) |
| bostick1994 | 1.04 (0.62–1.76) | 8.7 | Appendix III: >11 vs <4 servings/week (red meat) |
| kato1997 | 1.23 (0.68–2.22) | 7.0 | Appendix III: Q4 vs Q1 (red meat) |
| singh1998 | 1.41 (0.90–2.21) | 10.9 | Appendix III: >=1 time/week vs never (red meat) |
| hsing1998 | 1.90 (0.90–4.30) | 4.3 | Appendix III: >=60 vs <15 times/month (red meat) |
| pietinen1999 | 0.80 (0.50–1.20) | 11.3 | exposure: unprocessed red meat Q4 vs Q1 |
| thun1992 | 1.14 (0.93–1.39) | 27.0 | Fig 2 (figure-read Thun entry) |

Leave-one-out: without willett1990: 1.21 (1.02–1.43); without chen1998: 1.27 (1.05–1.54); without giovannucci1994: 1.19 (1.01–1.41); without bostick1994: 1.29 (1.07–1.56); without kato1997: 1.27 (1.05–1.53); without singh1998: 1.25 (1.03–1.51); without hsing1998: 1.24 (1.04–1.47); without pietinen1999: 1.29 (1.12–1.48); without thun1992: 1.31 (1.06–1.62)

## HvL (Norat's 9-cohort set) – corrected: inclusion

**Pooled: 1.35 (1.13–1.62)** (fixed 1.35 (1.13–1.62); I² 0 %; k = 7). 

| Study | RR (95 % CI) | Weight % | Source / choice |
|---|---|---|---|
| willett1990 | 1.77 (1.09–2.88) | 13.9 | Appendix III: >=134 vs <59 (g/day) |
| chen1998 | 1.17 (0.68–2.02) | 11.1 | Appendix III: >1 vs <=0.5 servings/day (red meat) |
| giovannucci1994 | 1.71 (1.15–2.55) | 20.7 | Appendix III: 129.5 vs 18.5 g/day (red meat) |
| bostick1994 | 1.04 (0.62–1.76) | 12.1 | Appendix III: >11 vs <4 servings/week (red meat) |
| kato1997 | 1.23 (0.68–2.22) | 9.4 | Appendix III: Q4 vs Q1 (red meat) |
| singh1998 | 1.41 (0.90–2.21) | 16.3 | Appendix III: >=1 time/week vs never (red meat) |
| pietinen1999 | 1.10 (0.70–1.70) | 16.7 | Appendix III: 203 vs 79 g/day (red meat) |

Leave-one-out: without willett1990: 1.30 (1.07–1.58); without chen1998: 1.38 (1.14–1.67); without giovannucci1994: 1.27 (1.04–1.56); without bostick1994: 1.40 (1.16–1.70); without kato1997: 1.37 (1.13–1.66); without singh1998: 1.34 (1.10–1.64); without pietinen1999: 1.41 (1.16–1.72)

## HvL (Norat's 9-cohort set) – corrected: all classes

**Pooled: 1.27 (1.02–1.59)** (fixed 1.28 (1.07–1.54); I² 34 %; k = 7). 

| Study | RR (95 % CI) | Weight % | Source / choice |
|---|---|---|---|
| willett1990 | 1.77 (1.09–2.88) | 14.2 | Appendix III: >=134 vs <59 (g/day) |
| chen1998 | 1.17 (0.68–2.02) | 12.1 | Appendix III: >1 vs <=0.5 servings/day (red meat) |
| giovannucci1994 | 1.71 (1.15–2.55) | 18.2 | Appendix III: 129.5 vs 18.5 g/day (red meat) |
| bostick1994 | 1.04 (0.62–1.76) | 12.9 | Appendix III: >11 vs <4 servings/week (red meat) |
| kato1997 | 1.23 (0.68–2.22) | 10.7 | Appendix III: Q4 vs Q1 (red meat) |
| singh1998 | 1.41 (0.90–2.21) | 15.7 | Appendix III: >=1 time/week vs never (red meat) |
| pietinen1999 | 0.80 (0.50–1.20) | 16.2 | exposure: unprocessed red meat Q4 vs Q1 |

Leave-one-out: without willett1990: 1.21 (0.96–1.53); without chen1998: 1.29 (0.99–1.67); without giovannucci1994: 1.19 (0.94–1.51); without bostick1994: 1.31 (1.02–1.69); without kato1997: 1.28 (0.99–1.65); without singh1998: 1.25 (0.96–1.63); without pietinen1999: 1.41 (1.16–1.72)

## HvL – corrected + follow-ups

**Pooled: 1.01 (0.88–1.16)** (fixed 1.01 (0.88–1.16); I² 0 %; k = 7). 

| Study | RR (95 % CI) | Weight % | Source / choice |
|---|---|---|---|
| willett1990 | 0.96 (0.76–1.21) | 34.9 | follow-up: NHS → Bernstein 2015 women >1 svg/d vs lowest, unprocessed red meat |
| chen1998 | 1.17 (0.68–2.02) | 6.4 | Appendix III: >1 vs <=0.5 servings/day (red meat) |
| giovannucci1994 | 0.98 (0.75–1.27) | 27.2 | follow-up: HPFS → Bernstein 2015 men >1 svg/d vs lowest, unprocessed red meat |
| bostick1994 | 1.04 (0.62–1.76) | 6.9 | Appendix III: >11 vs <4 servings/week (red meat) |
| kato1997 | 1.23 (0.68–2.22) | 5.4 | Appendix III: Q4 vs Q1 (red meat) |
| singh1998 | 1.41 (0.90–2.21) | 9.4 | Appendix III: >=1 time/week vs never (red meat) |
| pietinen1999 | 0.80 (0.50–1.20) | 9.8 | exposure: unprocessed red meat Q4 vs Q1 |

Leave-one-out: without willett1990: 1.04 (0.88–1.24); without chen1998: 1.00 (0.87–1.16); without giovannucci1994: 1.03 (0.87–1.21); without bostick1994: 1.01 (0.88–1.17); without kato1997: 1.00 (0.87–1.16); without singh1998: 0.98 (0.85–1.13); without pietinen1999: 1.04 (0.90–1.20)

## Deviations (synthesis vs primary paper)

| Outcome | Study | Class | Deviation | Page | Alternative used |
|---|---|---|---|---|---|
| colon/colorectal | pietinen1999 | exposure | Norat's ATBC row (203 vs 79 g/day) is red meat including processed (Pietinen Table 5); the paper's red meat (beef, pork, lamb) row 99 vs 35 g/day gives 0.8 (0.5–1.2) | Pietinen 1999 Table 5; Chan 2011 S1 | 0.80 (0.50–1.20) – unprocessed red meat Q4 vs Q1 |
| colon/colorectal | hsing1998 | inclusion | fatal colorectal cancer only (Lutheran Brotherhood mortality cohort) | Hsing 1998 | removed |
| colon/colorectal | chen1998 | inclusion | nested case-control (Physicians' Health Study) | Chen 1998 | none available (documented only) |
| colon/colorectal | giovannucci1994 | exposure | HPFS 'red meat' here is total red meat including processed (Giovannucci Table 2, beef/pork/lamb + processed) | Giovannucci 1994 Table 2 | none available (documented only) |
| colon/colorectal | willett1990 | exposure | NHS 'red meat' quintiles (g/day) include processed meat | Willett 1990 Table 4 p1668 | none available (documented only) |
| colon/colorectal | thun1992 | inclusion | CPS-II mortality cohort (fatal colon cancer); value read off Fig 2, not printed | Thun 1992; Norat Fig 2 | removed |
| colon/colorectal | thun1992 | transcription | Thun 1992 prints quintile-5 'fatty meats' RRs of 1.21 (men) and 1.05 (women) with NO confidence intervals (Table 4, unadjusted, conditional logistic); the single entry plotted in Norat's Fig 2 (≈1.14, 0.91–1.38) with a CI is therefore Norat's own construction, from inputs the paper does not print | Thun 1992 Table 4 p1495; Norat Appendix III p255; Fig 2 p245 | none available (documented only) |

## Notes

- Per-study values behind Fig 2 (HvL) and Fig 4 (per 120 g) are not printed; the cohort HvL stratum reproduces only with one value read off the figure (R3 not met strictly). Missing from the printed pool: thun1992.