EPIC-Oxford (Appleby, 2016) found no difference in all cancer mortality between vegetarians (including vegans) and regular meat-eaters (0.93, 0.82-1.05). Vegetarians had lower rates of death from pancreatic (0.48, 0.28-0.82) and lymphatic (0.50, 0.32-0.79), but not colorectal, lung, breast, or ovary cancers.
This article will address the subject of cancer rates in vegetarians. Very little data exists for vegans. The tables in this article are extracted from all studies that have looked at vegetarians and show the rates of cancer mortality (how many people died from the disease) or incidence (how many people contracted the disease).
Each table below looks at a different type of cancer and whether there has been a difference in risk between vegetarians and non-vegetarians.
Some things to keep in mind:
Although the 2012 paper from Adventist Health Study-2 (Tantamango-Bartley, 2012) found some statistically significant differences between vegetarians and non-vegetarians for some specific cancers, they included semi- and pesco-vegetarians in the “vegetarian” category and thus are not listed below. Individual cancer categories were analyzed among the diet groups and female vegans had a lower risk of “all female cancers” before adjusting for body mass index (BMI). Vegans also had a slightly higher rate of urinary tract cancers after adjusting for BMI.
In order for the rate to be statistically significant, the numbers in the confidence interval (in the parentheses) must both either be less than 1.00 or greater than 1.00.
EPIC-Oxford: Cancer Mortality (2016)
EPIC-Oxford (Appleby, 2016) found no difference in all cancer mortality between vegetarians (including vegans) and regular meat-eaters (0.93, 0.82-1.05). Vegetarians had lower rates of death from pancreatic (0.48, 0.28-0.82) and lymphatic (0.50, 0.32-0.79), but not colorectal, lung, breast, or ovary cancers.
After excluding participants who changed diet categories during the study, vegetarians had a lower risk of all cancer (0.82, 0.72-0.94), and similar findings as above for the other cancers.
Vegans suffered from 67 deaths from cancer, with a rate not significantly different from regular meat-eaters (1.14, 0.88-1.47).
General Cancer
Table 1 shows that the 2014 study from EPIC-Oxford is the first to show vegetarians to have a lower cancer rate than non-vegetarians (not including pesco-vegetarians). It took 14.9 years of follow-up before a statistically significant difference developed.
Table 1. Risk for All Cancers Combined Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2010 Non-Veg 1.00 Pesco-Veg .88 (.80, .97) Vegetarians .88 (.82, .95) smoking, alcohol, physical activity level, gender, study, recruitment method Incidence EPIC-OxfordB 1993-2005 Non-Veg 1.00 Vegetarians .93 (.71, 1.04) age, gender, smoking Incidence EPIC-OxfordC 1993-2002 Non-Veg 1.00 Vegetarians 1.11 (.82, 1.51) age, gender, smoking Mortality Oxford VegetarianD 1980-2000 Non-Veg 1.00 Vegetarians 1.06 (.85, 1.34) age, gender, smoking; excluded first 5 years of follow-up Mortality Health Food ShoppersD 1973-1997 Non-Veg 1.00 Vegetarians 1.18 (.99, 1.41) age, gender, smoking; excluded first 5 years of follow-up Mortality Heidelberg VegetarianE 1978-1989 Non-Veg 1.00 Vegetarians 1.59 (.87, 2.94) gender, duration of diet, BMI (smoking did not effect results) Mortality. Non-vegetarians ate meat “occasionally.”
Table 2 shows that the most recent reports from both AHS-2 and EPIC-Oxford found a lower cancer rate in vegans compared to non-vegetarians.
Table 2. Risk For All Cancers Combined Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2010 Non-Veg 1.00 Pesco .88 (.80, .97) Lacto-ovo .89 (.83, .96) Vegan .81 (.66, .98) smoking, alcohol, physical activity level, gender, study, recruitment method Incidence Adventist Health Study-2B 2002-2006 Non-Veg 1.00 Semi .98 (.82, 1.17) Pesco .88 (.77, 1.01) Lacto-ovo .93 (.85, 1.02) Vegan .84 (.72, .99) age, race, family history of cancer, education, smoking, alcohol, age at menarche, pregnancies, breastfeeding, oral contraceptives, hormone replacement therapy, and menopause status. Adjusting for physical activity did not change the results. Incidence Adventist Health Study-2B 2002-2006 Non-Veg 1.00 Semi .98 (.83, 1.18) Pesco .89 (.77, 1.03) Lacto-ovo .95 (.86, 1.04) Vegan .86 (.73, 1.00) Same as above, plus BMI Incidence EPIC-Oxford C 1993-2006 Non-Vega 1.00 Vegetarians .88 (.81, .96) Pescob .82 (.73, .93) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence EPIC-OxfordD 1993-2005 Non-Vega 1.00 Vegetarians .89 (.80, 1.00) Pescob .83 (.71, .96) age, gender, smoking Incidence
Specific Cancers
The tables below do not include the results of the 2014 EPIC-Oxford (Key, 2014) or 2015 EPIC-Oxford (Appleby, 2016) reports. These reports are starting to contain so many different analyses that maintaining these tables is becoming unwieldy; we are assessing whether to change the format to something much simpler.
Colorectal Cancer
Table 3 shows one study that found a higher risk of colorectal cancer for vegetarians and one study that found a lower risk.
Table 3. Risk For Colorectal Cancer. Study Years Risk and Confidence Interval Adjustments Notes Netherlands Cohort StudyA 1986-2006 Non-Veg 1.00 Vegetarians .78 (.51, 1.20) age, gender Incidence Netherlands Cohort StudyA 1986-2006 Non-Veg 1.00 Vegetarians .89 (.58, 1.39) age, gender, energy, smoking, alcohol, BMI, physical activity, education Incidence EPIC-OxfordB 1993-2010 Non-Veg 1.00 Pesco-Veg .66 (.48, .92) Vegetarians 1.03 (.84, 1.26) smoking, alcohol, physical activity level, gender, study, recruitment method Incidence EPIC-OxfordC 1993-2005 Non-Veg 1.00 Vegetarians 1.49 (1.09, 2.03) age, gender, smoking Incidence Oxford VegetarianD 1980-2000 Non-Veg 1.00 Vegetarians 1.42 ( .76, 2.67) age, gender, smoking; excluded first 5 years of follow-up Mortality Oxford VegetarianE 1980-1999 Non-Veg 1.00 Vegetarians .85 ( .55, 1.32) age, sex, alcohol, smoking Incidence Meta-AnalysisF 1999 Non-Veg 1.00 Vegetarians .99 ( .77, 1.27) age, gender, smoking, and study Mortality Health Food ShoppersD 1973-1997 Non-Veg 1.00 Vegetarians .85 ( .52, 1.39) age, gender, smoking; excluded first 5 years of follow-up Mortality Adventist HealthG 1976-1982 Non-Veg 1.00 Vegetarians .53 ( .35, .81) age, gender Incidence
Table 4 divides populations into more specific diet groups:
Table 5. Risk For Prostate Cancer. Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2005 Non-Veg 1.00 Vegetarians .90 (.61, 1.33) age, gender, smoking Incidence Oxford VegetarianB 1980-2000 Non-Veg 1.00 Vegetarians .66 (.27, 1.59) age, gender, smoking; excluded first 5 years of follow-up Mortality Meta-AnalysisC 1999 Non-Veg 1.00 Vegetarians .91 (.60, 1.39) age, gender, smoking, and study Mortality Health Food ShoppersB 1973-1997 Non-Veg 1.00 Vegetarians 1.29 (.62, 2.68) age, gender, smoking; excluded first 5 years of follow-up Mortality Adventist HealthD 1976-1982 Non-Veg 1.00 Vegetarians .65 (.44, .95) age, gender Incidence. 6 years of follow up.
In AHS-2, vegans had a lower risk than regular meat-eaters, even after adjusting for BMI. In EPIC-Oxford, fish-eaters had a statistically significant, lower rate of prostate cancer than regular meat eaters. See Table 6 below.
Table 6. Risk For Prostate Cancer. Study Years Risk and Confidence Interval Adjustments Notes AHS-2A 2002-2013 Non-Vega 1.00 Semi-Vegc 1.18 (.91, 1.54) Pescob 1.07 (.88, 1.31) Lacto-Ovo .96 (.83, 1.12) Vegan .66 (.50, .87) Age, race, family history, education, screening, caloric intake, BMI Incidence EPIC-OxfordB 1993-2006 Non-Vega 1.00 Vegetarians .87 (.64, 1.18) Pescob .57 (.33, .99) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Breast Cancer
Unfortunately, the one (barely) significant finding was that vegetarians had more breast cancer in the Health Food Shoppers study. See Table 7 below. That study did not adjust for having children which is protective against breast cancer, and vegetarian women tend to have fewer children.
Table 7. Risk For Breast Cancer. Study Years Risk and Confidence Interval Adjustments Notes AHS-2A 2002-2011 Non-Veg 1.00 Semi .91 (.67, 1.23) Pesco .91 (.71, 1.17) Lacto-ovo 1.05 (.89, 1.23) Vegan .78 (.58, 1.05) All Veg .97 (.84, 1.11) race, height, physical activity, family history of cancer, mammography, age at menopause, age at menarche, birth control pills, hormone replacement therapy, age at first child, number of children, breastfeeding, educational level, smoking, alcohol Incidence EPIC-OxfordB 1993-2005 Non-Veg 1.00 Vegetarians .94 (.77, 1.13) age, gender, smoking Incidence Oxford VegetarianC 1980-2000 Non-Veg 1.00 Vegetarians 1.23 (.66, 2.31) age, smoking; excluded first 5 years of follow-up Mortality Meta-AnalysisD 1999 Non-Veg 1.00 Vegetarians .95 (.55, 1.63) age, smoking, and study Mortality South Asian-Born Women Living in UKE 1995-1999 Non-Veg 1.00 Vegetarians .77 (.50, 1.19) age, smoking; excluded first 5 years of follow-up Incidence. Case control. Health Food ShoppersC 1973-1997 Non-Veg 1.00 Vegetarians 1.62 (1.01, 2.60) age, smoking; excluded first 5 years of follow-up Mortality IndiaF 1980-1984 Non-Veg 1.00 Vegetarians 1.25 (.48, 1.67) age, region Incidence. Case control. Adventist HealthG 1976-1982 Non-Veg 1.00 Vegetarians .80 (.56, 1.15) age Incidence. 6 years of follow up.
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Table 8. Rates for Breast Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians .91 (.77, 1.08) Pescob 1.05 (.86, 1.28) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Lung Cancer
Table 9. Rates for Lung Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2005 Non-Veg 1.00 Vegetarians 1.23 (.69, 2.17) age, gender, smoking Incidence Oxford VegetarianB 1980-2000 Non-Veg 1.00 Vegetarians 1.27 (.60, 2.68) age, gender, smoking; excluded first 5 years of follow-up Mortality Meta-AnalysisC 1999 Non-Veg 1.00 Vegetarians .84 (.59, 1.18) age, gender, smoking, and study Mortality Health Food ShoppersB 1973-1997 Non-Veg 1.00 Vegetarians 1.19 (.70, 2.02) age, gender, smoking; excluded first 5 years of follow-up Mortality Adventist HealthD 1976-1982 Non-Veg 1.00 Vegetarians .86 (.42, 1.79) age, gender Incidence. 6 years of follow up.
Table 10. Rates for Lung Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians 1.11 (.75, 1.65) Pescob .59 (.29, 1.23) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Ovarian Cancer
Table 11. Rates for Ovarian Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2005 Non-Veg 1.00 Vegetarians .85 (.49, 1.46) age, gender, smoking Incidence
Table 12. Rates for Ovarian Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians .69 (.45, 1.07) Pescob .37 (.18, .77) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Uterine Cancer
Table 13. Rates for Uterine Cancer Study Years Risk and Confidence Interval Adjustments Notes Adventist HealthA 1976-1982 Non-Veg 1.00 Vegetarians .85 (.58, 1.23) age, gender Incidence. 6 years of follow up.
Stomach Cancer
Table 14. Risk for Stomach Cancer Study Years Risk and Confidence Interval Adjustments Notes Meta-AnalysisA 1999 Non-Veg 1.00 Vegetarians 1.02 (.64, 1.62) age, gender, smoking, and study Mortality
Table 15. Risk for Stomach Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians .36 (.16, .78) Pescob .29 (.07, 1.20) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Pancreatic Cancer
Table 16 shows that vegetarians had about half the rate of pancreatic cancer compared to people who ate meat more than once
daily. In comparison to all meat eaters, the rates were not significantly different.
Table 16. Risk for Pancreatic Cancer Study Years Risk and Confidence Interval Adjustments Notes Adventist HealthA 1976-1982 Non-Veg 1.00 Vegetarians .46 ( .06, 1.39) Vegetarians 1.00 Non-Vega 2.18 (1.04, 4.58) age, sex, smoking, other foods age, gender Mortality
Table 17. Risk for Pancreatic Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians .94 (.52, 1.71) Pescob .82 (.34, 1.96) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Brain Cancer
Among people who ate meat more than once daily, there were no cases of meningioma cancer and this finding was statistically significant (see Table 18 below.)
Table 18. Risk for Brain Cancer Study Years Risk and Confidence Interval Adjustments Notes Adventist HealthA 1976-1982 Glioma Cancer Vegetarians 1.00 Non-Vega 1.56 (.52, 5.63) Non-Vegb 1.75 (.34, 8.54) Meningioma Cancer Vegetarians 1.00 Non-Vega .36 (.09, 1.46) Non-Vegb 0 (P < .05) age, gender Incidence. 6 years of follow up.
Table 19. Risk for Brain Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians 1.25 (.72, 2.16) Pescob 1.39 (.69, 2.80) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Oral Cancer
Vegetarians, as shown in Table 20 below, had significantly lower rates of oral cancer in this study of Indian vegetarians.
Table 20. Risk for Oral Cancer Study Years Risk and Confidence Interval Adjustments Notes IndiaA 1980-1984 Non-Veg 1.00 Vegetarians .55 (.40, .74) age, region Incidence. Case control.
Cancer of the Upper Digestive Tract
Table 21. Risk for Cancer of the Upper Digestive Tract Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians .81 (.45, 1.46) Pescob .44 (.16, 1.25) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Cervical Cancer
Table 22. Risk for Cervical Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians 2.08 (1.05, 4.12) Pescob 2.05 ( .91, 4.63) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Melanoma
Table 23. Risk for Melanoma Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians .89 (.61, 1.29) Pescob .90 (.55, 1.47) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Endometrial Cancer
Table 24. Risk for Endometrial Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians .75 (.45, 1.28) Pescob .61 (.29, 1.30) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Kidney Cancer
Table 25. Risk for Kidney Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians .76 (.36, 1.58) Pescob .36 (.09, 1.52) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
Bladder Cancer
Table 26. Risk for Bladder Cancer Study Years Risk and Confidence Interval Adjustments Notes EPIC-OxfordA 1993-2006 Non-Vega 1.00 Vegetarians .47 (.25, .89) Pescob .81 (.36, 1.81) age, gender, smoking, alcohol, BMI, physical activity, parity, oral contraceptives, method of recruitment Incidence
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