Raw and cooked vegetables, fruits, selected micronutrients, and breast cancer risk: a case-control study in Germany

In 1998-2000, a case-control study of breast cancer was conducted in Heidelberg, Germany. Three hundred ten consecutively recruited cases with primary breast cancer were matched according to 10-yr age groups to 353 controls with conditions unrelated to diet or endocrine disorders. Intake of raw vegetables, total vegetables, and whole-grain products was inversely associated with breast cancer risk (highest vs. lowest quartile adjusted odds ratio [OR] 0.51, 95% confidence interval [CI] 0.31-0.84; OR = 0.62, 95% CI = 0.38-1.02; and OR = 0.57; 95% CI = 0.34-0.95, respectively). Also, high intake of some selected vitamins and minerals possessing putative DNA-stabilizing properties displayed significant inverse risk associations. Adjusted ORs were as follows: vitamin C (OR = 0.49, 95% CI = 0.2-0.88), folate equivalents (OR = 0.47, 95% CI = 0.25-0.88), b-carotene (OR = 0.46, 95% CI = 0.27-0.80), zinc (OR = 0.35, 95% CI = 0.15-0.78), and copper (OR = 0.51, 95% CI = 0.31-1.03). In contrast, no significant association with risk was seen for an increased intake of fruits, cooked vegetables, fiber, calcium, manganese, or iron. In this population of German women, components of raw vegetables and some micronutrients appear to decrease breast cancer risk.     

Intake of fruits, vegetables, and soy foods in relation to breast cancer risk in Korean women: a case-control study

We conducted a case-control study to examine the relationship between fruit, vegetable, and soy food intake and breast cancer risk in Korean women. Incident cases (n=359) were identified through cancer biopsies between March 1999 and August 2003 at two university hospitals in Seoul, Korea. Hospital-based controls (n=708) were selected from patients in the same hospitals during the same period. Subjects were asked by personal interview to indicate their average fruit, vegetable, and soy food intake for a 12-mo period 3 yr prior to the baseline phase. A food intake-frequency questionnaire (98 items) was given by a trained dietitian. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression after adjustment for confounding factors and total energy intake. There was no association between the intake of total fruits, vegetables, or soy food and breast cancer risk. Increasing consumption of grapes was linked to a significant protective effect against risk of breast cancer (OR=0.66; 95% CI=0.41-0.86; P<0.01). Among the vegetables, reduced risk was observed with high tomato intake (OR=0.62; 95% CI=0.38-0.81; P<0.01). Among soy foods, high consumption of cooked soybeans, including yellow and black soybeans, had an association with reduced breast cancer (OR=0.67; 95% CI=0.45-0.91; P<0.02). Our data suggest that increased intake of some fruits, vegetables, and soy foods may be associated with breast cancer risk reduction in Korean women.     

A prospective study of occupation and prostate cancer risk

A wide variety of occupations has been associated with prostate cancer in previous retrospective studies. Most attention has been paid to farming, metal working, and the rubber industry. Today, these results cannot be affirmed with confidence, because many associations could be influenced by recall bias, have been inconsistent, or have not been confirmed satisfactory in subsequent studies. This study was conducted to investigate and confirm these important associations in a large prospective cohort study. The authors conducted a prospective cohort study among 58,279 men. In September 1986, the cohort members (55-69 years) completed a self-administered questionnaire on potential cancer risk factors, including job history. Related job codes were clustered in professional groups. These predefined clusters were investigated in 3 time windows: 1) profession ever performed, 2) longest profession ever held, and 3) last profession held at baseline. Follow up for incident prostate cancer was established by linkage to cancer registries until December 1993. A case-cohort approach was used based on 830 cases and 1525 subcohort members. To minimize false-positive results, 99% confidence intervals (99% CI) were calculated. Although moderately decreased prostate cancer risks were found for electricians, farmers, firefighters, woodworkers, textile workers, butchers, salesmen, teachers, and clerical workers, none of the relative risks (RR) were found to be statistically significant. For road transporters, metal workers, and managers, no association with prostate cancer risk was found. Although the RR for railway workers, mechanics, welders, chemists, painters, and cooks was moderately increased, these estimates were not statistically significant. For men who reported to have ever worked in the rubber industry, we found a substantially increased prostate cancer risk, but not statistically significant (RR, 4.18; 99% CI = 0.22-80.45). For policemen, we found a substantial and marginally statistically significant increased prostate cancer risk, especially for those who reported working as a policeman for most of their occupational life (RR, 3.91; 99% CI = 1.14-13.42) or as the last profession held at baseline (RR, 4.00; 99% CI = 1.19-13.37). Most of the previously investigated associations between occupation and prostate cancer risk could not be confirmed with confidence in this prospective study. The lack of statistical significance for rubber workers could be caused by the scarcity of rubber workers in this cohort and subsequent lack of power. The results for policemen were substantial and statistically significant, although a conservative value for significance level was used.     

Prospective study of fruits and vegetables and risk of oral premalignant lesions in men

The authors prospectively evaluated fruit and vegetable consumption and the incidence of oral premalignant lesions among 42,311 US men in the Health Professionals Follow-up Study. Diet was assessed every 4 years by food frequency questionnaires. The authors confirmed 207 cases of clinically or histopathologically diagnosed oral premalignant lesions occurring between 1986 and 2002. Multivariate-adjusted relative risks were calculated from proportional hazards models. Significant inverse associations were observed with citrus fruits, citrus fruit juice, and vitamin-C-rich fruits and vegetables, indicating 30-40% lower risks with greater intakes (e.g., citrus fruit juice quintile 5 vs. quintile 1 relative risk = 0.65, 95% confidence interval: 0.42, 0.99). Inverse associations with fruits did not vary by smoking status and were stronger in analyses of baseline consumption, with a 10-year lag time to disease follow-up (quintile 5 vs. quintile 1 relative risk = 0.41, 95% confidence interval: 0.20, 0.82; p = 0.01). No associations were observed with total vegetables or with beta-carotene-rich or lycopene-rich fruits and vegetables. For current smokers, green leafy vegetables (ptrend = 0.05) and beta-carotene-rich fruits and vegetables (ptrend = 0.02) showed significant linear trends of increased risk (one additional serving/day relative risk = 1.7). The risk of oral premalignant lesions was significantly reduced with higher consumption of fruits, particularly citrus fruits and juices, while no consistent associations were apparent for vegetables.     

Caffeinated coffee, decaffeinated coffee and endometrial cancer risk: a prospective cohort study among US postmenopausal women

There is plausible biological evidence as well as epidemiologic evidence to suggest coffee consumption may lower endometrial cancer risk. We evaluated the associations between self-reported total coffee, caffeinated coffee and decaffeinated coffee, and endometrial cancer risk using the Women's Health Initiative Observational Study Research Materials obtained from the National Heart, Lung, and Blood Institute Biological Specimen and Data Repository Coordinating Center. Our primary analyses included 45,696 women and 427 incident endometrial cancer cases, diagnosed over a total of 342,927 person-years of follow-up. We used Cox-proportional hazard models to evaluate coffee consumption and endometrial cancer risk. Overall, we did not find an association between coffee consumption and endometrial cancer risk. Compared to non-daily drinkers (none or <1 cup/day), the multivariable adjusted hazard ratios for women who drank ≥4 cups/day were 0.86 (95% confidence interval (CI) 0.63, 1.18) for total coffee, 0.89 (95% CI 0.63, 1.27) for caffeinated coffee, and 0.51 (95% CI 0.25, 1.03) for decaf coffee. In subgroup analyses by body mass index (BMI) there were no associations among normal-weight and overweight women for total coffee and caffeinated coffee. However among obese women, compared to the referent group (none or <1 cup/day), the hazard ratios for women who drank ≥2 cups/day were: 0.72 (95% CI 0.50, 1.04) for total coffee and 0.66 (95% CI 0.45, 0.97) for caffeinated coffee. Hazard ratios for women who drank ≥2 cups/day for decaffeinated coffee drinkers were 0.67 (0.43-1.06), 0.93 (0.55-1.58) and 0.80 (0.49-1.30) for normal, overweight and obese women, respectively. Our study suggests that caffeinated coffee consumption may be associated with lower endometrial cancer risk among obese postmenopausal women, but the association with decaffeinated coffee remains unclear.     

Sociodemographic status, stress, and risk of prostate cancer. A prospective cohort study

PURPOSE: The social gradient in prostate cancer incidence observed in several studies may be a result of differential access to prostate cancer screening. We aim to assess if socioeconomic status, stress, and marital status are associated with prostate cancer risk in a population with free access to health care. METHODS: The 5,496 men who participated in the Copenhagen City Heart Study were asked about their income, educational level, stress level, and marital status during 1981-1983. These men were prospectively followed up in the Danish Cancer Registry until the end of 2002 and fewer than 0.1 % were lost to follow-up. RESULTS: During follow-up, 157 men were diagnosed with prostate cancer. Neither high income (HR = 1.17, 95% confidence interval [CI]: 0.78-1.76) nor high education (HR = 1.22; 95% CI: 0.76-1.96) were associated with risk of prostate cancer. There were also no differences in prostate cancer risk according to stress (HR = 0.99; 95% CI: 0.90-1.09) or marital status. CONCLUSION: In a racially homogeneous population of Caucasians with free access to health care, we found no evidence of a relation between sociodemographic variables or stress and subsequent risk of prostate cancer.     

A prospective study of job strain and risk of breast cancer

BACKGROUND: There is conflicting evidence on whether stress is a risk factor for breast cancer. The present study examined prospectively the relationship between stress at work and risk of breast cancer. METHODS: Participants comprised 26 936 postmenopausal women in the Nurses' Health Study ages 46-72 who were in paid employment, and who had no previous history of cancer. Multivariate-adjusted regression analysis was used to examine the relationship between job strain (measured by the Karasek Job Content Questionnaire in 1992) and risk of incident invasive and in situ breast cancer. RESULTS: From 1992 through 1994, 219 women were diagnosed with breast cancer. No evidence was found for a relationship between job stress and risk of breast cancer. Compared with women in low strain jobs, the multivariate-adjusted relative risks of breast cancer were RR = 0.78 (95% CI : 0.52-1.16) for high-strain jobs; RR = 0.76 (95% CI : 0.49-1.17) for active jobs; and RR = 0.94 (95% CI : 0.67-1.34) for passive jobs. Although job strain was related to less breast cancer screening among women in highly demanding jobs, it was not associated with tumour size. CONCLUSIONS: Job stress was not related to an increase in the incidence of breast cancer in the present cohort of nurses.     

Association between soy products,fruits, vegetables,and dairy products and gastric cancer risk in Helicobacter pylori-infected subjects: a case-control study in Korea

BACKGROUND/OBJECTIVESConsumption of certain protective foods may help inhibit Helicobacter pylori (H. pylori) associated gastric pathologies. However, studies conducted to assess the efficacy of protective foods in H. pylori-infected subjects are either limited or inconsistent. This study evaluated the association of individual or a combination of protective foods on the incidence of gastric cancer (GC) in H. pylori-positive subjects through a case-control study.MATERIALS/METHODSSubjects aged 20–79 years were selected from 2 hospitals between December 2002 and September 2006. In total, 134 patients and 212 controls tested positive for H. pylori infection. Among these, we included 82 pairs of cases and controls matched by sex, age (± 5 years), enrollment period (± 1 years), and hospital.RESULTSA higher intake of soy products was associated with a significantly lower risk of GC than a lower intake of soy products (odds ratio [OR] = 0.37, 95% confidence interval [CI] = 0.14–0.96). Additionally, a higher fruit intake resulted in a significantly lower risk of GC than a lower fruit intake (OR = 0.35, 95% CI = 0.13–0.94). A combination of food groups was evaluated, and a lower risk of GC was observed with a high intake of both soy products and fruits (OR = 0.20, 95% CI = 0.06–0.67), high intake of soy and dairy products (OR = 0.28, 95% CI = 0.10–0.78) and high intake of fruits and dairy products (OR = 0.28, 95% CI = 0.09–0.83).CONCLUSIONSA high intake of soy products or fruits was associated with a lower risk of GC. A combination of soy products or fruits with dairy products was associated with a lower risk of GC. A balanced intake of soy products, fruits, and dairy products may help reduce GC risk.     

Case-control study of dietary patterns and endometrial cancer risk

Dietary patterns, rather than intakes of specific foods or nutrients, may influence risk of endometrial cancer (EC). This population-based case-control study in Canada (2002-2006) included incident EC cases (n = 506) from the Alberta Cancer Registry and controls frequency age-matched to cases (n = 981). Past-year dietary patterns were defined using factor analysis of food frequency questionnaire data. Logistic regression was used to estimate EC risk within quartiles of dietary patterns. Three patterns (sweets, meat, plants) explained 23% of the variance in the dietary data. In multivariable models, EC risk was significantly reduced by 30% for women in the highest quartile of the healthier plants pattern (OR = 0.70, 95% CI 0.50-0.98, P trend = 0.02). When stratified by body mass index (BMI; kg/m(2)), risk was further reduced among overweight or obese women with a BMI ≥25 (OR = 0.57, 95% CI 0.39-0.83; P trend = 0.004). EC was not associated with the less healthy sweets and meat patterns. However, risk was modestly, but not significantly, elevated for higher intakes of the meat pattern among overweight or obese women. A mostly plant-based dietary pattern may reduce EC risk. Recommendations for risk reduction should focus on maintaining a healthy weight and the role of diet should be studied further.     

蔬菜水果摄入与前列腺癌风险的Meta分析

目的 系统评价蔬菜水果摄入与前列腺癌(prostate cancer,PCa)风险之间的关系,为前列腺癌的预防策略提供相关依据.方法 计算机检索Pubmed、Embase、Web of science数据库,查找评价蔬菜和/或水果摄入与前列腺癌风险之间关系的队列研究以及相关文献,对纳入的文献进行质量评级,采用R软件(4...     

宫内节育器与子宫内膜癌病例对照研究

目的探讨宫内节育器（IUD）使用与子宫内膜癌的关系。方法采用病例对照研究方法，调查上海市区1997年1月～2000年12月间确诊、年龄在30～69岁之间的子宫内膜癌患者（n=1204）和普通对照人群（n=1212）的一般情况、月经生育史、饮食、个人生活习惯、口服避孕药（OC）及宫内节育器使用情况、疾病及家族史等。采用非条件Logisfic回归模型分析宫内节育器使用与子宫内膜癌的关系。结果上海市区女性所使用的宫内节育器类型主要为金属环和V型塑料环。分别占使用者的68．1％和20．7％。与从未使用过宫内节育器的女性比较，使用者发生子宫内膜癌的危险性显著降低。调整后OR=0．57（95％CI=0．47～0．69），且随使用时间增加而降低。分层分析显示，在从未服用口服避孕药的女性中，曾使用IUD者发生子宫内膜癌的危险降低，OR=0．51（95％CI=0．41～0．64）。结论绝经前后女性使用宫内节育器可能会降低子宫内膜癌的风险。     

The protective role of fruits and vegetables against radiation-induced cancer

The role of fruits and vegetables in protecting against radiation-induced cancer and the positive evidence from epidemiology and ancillary investigations are discussed in this review. The recently reported Hiroshima and Nagasaki atomic bomb survivor studies provide strong evidence for the protective role of fruits and vegetables against radiation-induced cancer. The anticarcinogenic substances contained in, and the anticarcinogenic mechanisms proposed for, fruits and vegetables are reviewed. The anticarcinogenic effectiveness of fruits and vegetables are compared with that of dietary supplements. The reasons for the observed superiority of fruits and vegetables are advanced.     

A prospective study of tobacco, alcohol, and the risk of esophageal and gastric cancer subtypes

Rates of esophageal adenocarcinoma and gastric cardia adenocarcinoma have increased, while rates of esophageal squamous cell carcinoma (ESCC) and gastric noncardia adenocarcinoma have decreased, suggesting distinct etiologies. The authors prospectively investigated the associations of alcohol and tobacco with these cancers in 474,606 US participants using Cox models adjusted for potential confounders. Between 1995/1996 and 2000, 97 incident cases of ESCC, 205 of esophageal adenocarcinoma, 188 of gastric cardia, and 187 of gastric noncardia cancer occurred. Compared with nonsmokers, current smokers were at increased risk for ESCC (hazard ratio (HR) = 9.27, 95% confidence interval (CI): 4.04, 21.29), esophageal adenocarcinoma (HR = 3.70, 95% CI: 2.20, 6.22), gastric cardia (HR = 2.86, 95% CI: 1.73, 4.70), and gastric noncardia (HR = 2.04, 95% CI: 1.32, 3.16). Assuming causality, ever smoking had population attributable risks of 77% (95% CI: 0.55, 0.89) for ESCC, 58% (95% CI: 0.38, 0.72) for esophageal adenocarcinoma, 47% (95% CI: 0.27, 0.63) for gastric cardia, and 19% (95% CI: 0.00, 0.37) for gastric noncardia. For drinkers of more than three alcoholic beverages per day, compared with those whose intake was up to one drink per day, the authors found significant associations between alcohol intake and ESCC risk (HR = 4.93, 95% CI: 2.69, 9.03) but not risk for esophageal, gastric cardia, or gastric noncardia adenocarcinoma.     

A prospective study of multivitamin supplement use and risk of breast cancer

The authors evaluated the association between multivitamin supplement use and breast cancer risk in a completed trial. At baseline (1992-1995), 37,920 US women aged > or =45 years and free of cancer provided detailed information on multivitamin supplement use. During an average of 10 years of follow-up, 1,171 cases of invasive breast cancer were documented. Multivitamin use was not significantly associated with overall risk of breast cancer. Compared with the risk for never users, the multivariable relative risks were 0.97 (95% confidence interval: 0.81, 1.16) for past users and 0.99 (95% confidence interval: 0.82, 1.19) for current users. Current multivitamin use for > or =20 years or > or =6 times/week was also not significantly associated with risk. Multivitamin use was nonsignificantly inversely associated with risk of breast cancer among women consuming > or =10 g/day of alcohol and with risk of estrogen receptor negative-progesterone receptor negative breast cancer. Multivitamin use was nonsignificantly associated with a reduced risk of developing < or =2-cm breast tumors but an increased risk of >2-cm tumors. The authors' data indicate no overall association between multivitamin use and breast cancer risk but suggest that multivitamin use might reduce risk for women consuming alcohol or decrease risk of estrogen receptor negative-progesterone receptor negative breast cancer.     

Classification of fruits and vegetables

Classifications for fruits and vegetables are most helpful for dietary assessment and guidance if they are based on the composition of these foods. This work determined whether levels of food components in fruits and vegetables correlated with classification criteria based on botanic family, color, part of plant, and total antioxidant capacity (TAC). A database of 104 commonly consumed fruits and vegetables was created that contained food components known to be provided primarily by these foods. A mathematical clustering algorithm was used to group the foods into homogeneous clusters based on food component levels and the classification criteria. Most useful in categorizing were the botanic families rose, rue (citrus), amaryllis, goosefoot, and legume; color groupings blue/black, dark green/green, orange/peach, and red/purple; and plant parts fruit-berry, seeds or pods, and leaves. Groupings based on TAC levels did not match well with the identified clusters. Clusters were often best defined by a combination of classification variables such as color and part of plant. Results suggest that the groupings dark green leafy vegetables; cabbage family vegetables; lettuces; allium family bulbs; legumes; deep orange/yellow fruits, roots, and tubers; citrus family fruits; tomatoes and other red vegetables and fruits; and red/purple/blue berries are predictive for food components provided by fruits and vegetables.     

Intake of fruits and vegetables and risk of pancreatic cancer in a pooled analysis of 14 cohort studies

Fruit and vegetable intake may protect against pancreatic cancer, since fruits and vegetables are rich in potentially cancer-preventive nutrients. Most case-control studies have found inverse associations between fruit and vegetable intake and pancreatic cancer risk, although bias due to reporting error cannot be ruled out. In most prospective studies, inverse associations have been weaker and imprecise because of small numbers of cases. The authors examined fruit and vegetable intake in relation to pancreatic cancer risk in a pooled analysis of 14 prospective studies from North America, Europe, and Australia (study periods between 1980 and 2005). Relative risks and 2-sided 95% confidence intervals were estimated separately for the 14 studies using the Cox proportional hazards model and were then pooled using a random-effects model. Of 862,584 men and women followed for 7-20 years, 2,212 developed pancreatic cancer. The pooled multivariate relative risks of pancreatic cancer per 100-g/day increase in intake were 1.01 (95% confidence interval (CI): 0.99, 1.03) for total fruits and vegetables, 1.01 (95% CI: 0.99, 1.03) for total fruits, and 1.02 (95% CI: 0.99, 1.06) for total vegetables. Associations were similar for men and women separately and across studies. These results suggest that fruit and vegetable intake during adulthood is not associated with a reduced pancreatic cancer risk.     

Vitamin A, retinol, and carotenoids and the risk of gastric cancer: a prospective cohort study

BACKGROUND: Vitamin A may influence gastric carcinogenesis through its essential role in controlling cell proliferation and differentiation. However, epidemiologic studies of vitamin A, retinol (preformed vitamin A), and provitamin A carotenoids in relation to the risk of gastric cancer have documented inconsistent results. OBJECTIVE: The objective of the study was to examine the associations between intakes of vitamin A, retinol, and specific carotenoids and the risk of gastric cancer in a prospective population-based cohort study of Swedish adults. DESIGN: The study cohort consisted of 82 002 Swedish adults aged 45-83 y who had completed a food-frequency questionnaire in 1997. The participants were followed through June 2005. RESULTS: During a mean 7.2-y follow-up, 139 incident cases of gastric cancer were diagnosed. High intakes of vitamin A and retinol from foods only (dietary intake) and from foods and supplements combined (total intake) and of dietary alpha-carotene and beta-carotene were associated with a lower risk of gastric cancer. The multivariate relative risks for the highest versus lowest quartiles of intake were 0.53 (95% CI: 0.32, 0.89; P for trend = 0.02) for total vitamin A, 0.56 (95% CI: 0.33, 0.95; P for trend = 0.05) for total retinol, 0.50 (95% CI: 0.30, 0.83; P for trend = 0.03) for alpha-carotene, and 0.55 (95% CI: 0.32, 0.94; P for trend = 0.07) for beta-carotene. No significant associations were found for beta-cryptoxanthin, lutein and zeaxanthin, or lycopene intake. CONCLUSION: High intakes of vitamin A, retinol, and provitamin A carotenoids may reduce the risk of gastric cancer.