Cohort analysis of fruit and vegetable consumption and lung cancer mortality in European men

Our aim was to examine the relationship between fruit and vegetable consumption and lung cancer mortality in a cohort of European males. Around 1970, dietary intake of Finnish, Italian and Dutch middle-aged men was assessed using a cross-check dietary history. Complete baseline information was available for 3,108 men, of whom 1,578 were baseline smokers. We used Cox proportional hazard analyses to calculate risk estimates for the consumption in country-specific tertiles on lung cancer in smokers. During 25 years of follow-up, 149 lung cancer deaths occurred in the smokers. Fruit consumption was inversely associated with lung cancer mortality among smokers; compared with the lowest, adjusted RRs for the intermediate and highest tertiles were 0.56 (0.37-0.84) and 0.69 (0.46-1.02), p-trend 0.05. Only in the Dutch cohort was this association statistically significant [adjusted relative risks (RRs) 1.00, 0.33 (0.16-0.70) and 0.35 (0.16-0.74), p-trend 0.004]. In Finland lung cancer risk was lower with higher fruit intake but not significantly, whereas in Italy no association was observed. Stratifying on cigarette smoking intensity (non, light and heavy) revealed an inverse association in the heavy smokers only [adjusted RRs (95% confidence intervals [CI]) 1; 0.47 (0.26-0.84); 0.40 (0.20-0.78)). Vegetable consumption was not related to lung cancer risk in smokers. However, analyses stratified on cigarette smoking intensity gave some indication for a lower lung cancer risk with higher intake. In conclusion, in this prospective analysis among European smoking men, fruit intake was inversely related to lung cancer mortality. This association was confined to heavy cigarette smokers.     

Mediators of fruit and vegetable consumption among colorectal cancer survivors

Introduction  

Due to early detection and treatment, survival from colorectal cancer (CRC) diagnosis has been steadily increasing. A CRC diagnosis could be considered a “teachable moment,” a time when interventionists might successfully promote dietary changes. CRC interventions with tailored print communication (TPC) and telephone motivational interviewing (TMI) have been shown to be effective in promoting fruit and vegetable consumption (FVC) among CRC survivors. However, little is known about how these interventions work to exert their effect. This study investigated whether information processes mediate the relationship between a CRC intervention and FVC among CRC survivors.     

Prospective study of alcohol consumption and breast cancer risk in Japanese women

Epidemiologic evidence is lacking for the association between alcohol consumption and the risk of breast cancer in Japanese women. We addressed this association in a prospective cohort study with an average follow-up of 7.6 years. At baseline (1988-1990), cohort participants completed a self-administered questionnaire that included alcohol use, reproductive history and hormone use. The women were followed up for breast cancer incidence through December 31, 1997. Cox proportional hazards models were used to calculate relative risks (RRs) and 95% confidence intervals (CIs) for breast cancer incidence and any association with alcohol consumption. During a follow-up of 271,412 person-years, we identified 151 women with breast cancer, of whom 45 were current drinkers and 11 drank > or =15 g of alcohol/day. After adjustment for age and other potential risk factors for breast cancer, the RR for current drinkers was 1.27 (95% CI 0.87-1.84) compared to nondrinkers. Average alcohol intake of <15 g/day did not significantly increase the risk for breast cancer. However, risk was significantly increased for women who consumed > or =15 g/day of alcohol (RR = 2.93, 95% CI 1.55-5.54). Age at starting drinking and frequency of consumption per week were not significantly associated with breast cancer risk. Our cohort study demonstrated that Japanese women who consume at least a moderate amount of alcohol have an increased risk of breast cancer.     

Prospective study of vegetable consumption and liver cancer in Japan

We examined the relationship between vegetable consumption and the risk of death from liver cancer in a cohort study in Japan. This analysis is based on data from 6,049 subjects aged 40 to 79 years enrolled in a cohort study conducted in Fukuoka Prefecture, Japan. The follow-up period was from 1986 to 1999. All liver cancer deaths were recorded. The vegetable consumption was classified into 3 groups: "once per week or less," "2-4 times per week" and "daily intake." The Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence interval (95% CI). A total of 51 male and 22 female liver cancer deaths were recorded during 62,343 person-years of follow-up. The "once per week or less" group was considered the referent group. In males, the multivariate HRs of liver cancer deaths were 0.61 (95% CI: 0.33-1.14) and 0.25 (95% CI: 0.11-0.59) in the "2-4 times per week" and "daily intake" groups, respectively. In females, the multivariate HRs were 0.44 (95% CI: 0.13-1.51) and 0.51 (95% CI: 0.16-1.69), respectively. The multivariate HRs were also reported by history of hepatitis and cirrhosis. In those without a history of these conditions, the multivariate HRs were 0.54 (95% CI: 0.27-1.09) and 0.36 (95% CI: 0.16-0.83). In those with a history of these conditions, the multivariate HRs were 0.58 (95% CI: 0.22-1.56) and 0.37 (95% CI: 0.13-1.06), respectively. Our study reveals an inverse association between vegetable consumption and the risk of death from liver cancer. These results provide further evidence of the protective effect of vegetables against liver cancer.     

Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers

BACKGROUND: Frequent consumption of fruit and vegetables has been associated with a reduced risk of colorectal cancer in many observational studies. METHODS: We prospectively investigated the association between fruit and vegetable consumption and the incidence of colon and rectal cancers in two large cohorts: the Nurses' Health Study (88 764 women) and the Health Professionals' Follow-up Study (47 325 men). Diet was assessed and cumulatively updated in 1980, 1984, 1986, and 1990 among women and in 1986 and 1990 among men. The incidence of cancer of the colon and rectum was ascertained up to June or January of 1996, respectively. Relative risk (RR) estimates were calculated with the use of pooled logistic regression models accounting for various potential confounders. All statistical tests were two-sided. RESULTS: With a follow-up including 1 743 645 person-years and 937 cases of colon cancer, we found little association of colon cancer incidence with fruit and vegetable consumption. For women and men combined, a difference in fruit and vegetable consumption of one additional serving per day was associated with a covariate-adjusted RR of 1.02 (95% confidence interval [CI] = 0.98-1.05). A difference in vegetable consumption of one additional serving per day was associated with an RR of 1.03 (95% CI = 0.97-1.09). Similar results were obtained for women and men considered separately. A difference in fruit consumption of one additional serving per day was associated with a covariate-adjusted RR for colon cancer of 0.96 (95% CI = 0.89-1.03) among women and 1. 08 (95% CI = 1.00-1.16) among men. For rectal cancer (total, 244 cases), a difference in fruit and vegetable consumption of one additional serving per day was associated with an RR of 1.02 (95% CI = 0.95-1.09) in men and women combined. None of these associations was modified by vitamin supplement use or smoking habits. CONCLUSIONS: Although fruits and vegetables may confer protection against some chronic diseases, their frequent consumption does not appear to confer protection from colon or rectal cancer.     

Prospective study of dietary acrylamide and risk of colorectal cancer among women

There has been considerable discourse about whether exposure to acrylamide in foods could increase the risk of human cancer. Acrylamide is classified as a probable human carcinogen, and animal studies have demonstrated an increased incidence of tumors in rats exposed to very high levels. Still, epidemiologic data of the effect of dietary acrylamide remain scant. We have undertaken the first prospective study of acrylamide in food and risk of colon and rectal cancers using prospective data from the Swedish Mammography Cohort. The cohort comprised 61,467 women at baseline between 1987 and 1990. Through 2003, the cohort contributed 823,072 person-years, and 504 cases of colon and 237 of rectal cancer occurred. Mean intake of acrylamide through diet was 24.6 mug/day (Q25-70 = 18.7-29.9). Coffee (44%), fried potato products (16%), crisp bread (15%) and other breads (12%) were the greatest contributors. After adjusting for potential confounders, there was no association between estimated acrylamide intake and colorectal cancer. Comparing extreme quintiles, the adjusted relative risks (95% CI; p for trend) were for colorectal cancer 0.9 (0.7-1.3; p = 0.80), colon cancer 0.9 (0.6-1.4; p = 0.83) and rectal cancer 1.0 (0.6-1.8; p = 0.77). Furthermore, intake of specific food items with elevated acrylamide (e.g., coffee, crisp bread and fried potato products) was not associated with cancer risk. In this large prospective study, we found no evidence that dietary intake of acrylamide is associated with cancers of the colon or rectum. Epidemiologic studies play an important role in assessing the possible health effects of acrylamide intake through food.     

Variety in vegetable and fruit consumption and risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition

Recent research does not show an association between fruit and vegetable consumption and bladder cancer risk. None of these studies investigated variety in fruit and vegetable consumption, which may capture different aspects of consumption. We investigated whether a varied consumption of vegetables and fruits is associated with bladder cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Detailed data on food consumption and complete follow-up for cancer incidence were available for 452,185 participants, who were recruited from ten European countries. After a mean follow-up of 8.7 years, 874 participants were diagnosed with bladder cancer. Diet diversity scores (DDSs) were used to quantify the variety in fruit and vegetable consumption. Multivariable Cox proportional hazard models were used to assess the effect of the DDSs on bladder cancer risk. There was no evidence of a statistically significant association between bladder cancer risk and any of the DDSs when these scores were considered as continuous covariates. However, the hazard ratio (HR) for the highest tertile of the DDS for combined fruit and vegetable consumption was marginally significant compared to the lowest (HR = 1.30, 95% confidence interval: 1.00-1.69, p-trend = 0.05). In EPIC, there is no clear association between a varied fruit and vegetable consumption and bladder cancer risk. This finding provides further evidence for the absence of any strong association between fruit and vegetable consumption as measured by a food frequency questionnaire and bladder cancer risk.     

Prospective cohort study of green tea consumption and colorectal cancer risk in women.

Tea and its constituents have shown anticarcinogenic activities in in vitro and animal studies. Epidemiologic studies, however, have been inconsistent. We prospectively evaluated the association between green tea consumption and colorectal cancer (CRC) risk in a cohort of 69,710 Chinese women aged 40 to 70 years. Information on tea consumption was assessed through in-person interviews at baseline and reassessed 2 to 3 years later in a follow-up survey. During 6 years of follow-up, 256 incident cases of CRC were identified. The multivariate relative risk of CRC was 0.63 (95% confidence interval, 0.45-0.88) for women who reported drinking green tea regularly at baseline compared with nonregular tea drinkers. A significant dose-response relationship was found for both the amount of tea consumed (Ptrend = 0.01) and duration in years of lifetime tea consumption (Ptrend = 0.006). The reduction in risk was most evident among those who consistently reported to drink tea regularly at both the baseline and follow-up surveys (relative risk, 0.43; 95% confidence interval, 0.24-0.77). The inverse association with regular tea drinking was observed for both colon and rectal cancers. This study suggests that regular consumption of green tea may reduce CRC risk in women.     

Greater vegetable and fruit intake is associated with a lower risk of breast cancer among Chinese women

The effect of vegetable and fruit consumption on breast cancer risk is controversial. We examined the association between vegetable and fruit intake and breast cancer risk in a hospital‐based case–control study conducted in Guangdong, China. Four hundred and thirty‐eight cases were frequency matched to 438 controls by age (5‐year interval) and residence (rural/urban). Dietary intake was assessed by face‐to‐face interviews using a validated food frequency questionnaire. Multivariate logistic regression was used to estimate the odds ratios (ORs) and 95% confidence interval (CI) after adjusting for various potential confounders. Total vegetable and fruit intake was found to be inversely associated with breast cancer risk. The ORs of the highest quartile relative to the lowest quartile of total vegetable and fruit intake were 0.28 (95% CI 0.18–0.43) and 0.53 (95% CI 0.34–0.82), respectively. Consumption of individual vegetable and fruit groups such as dark green leafy vegetables, cruciferous vegetables, carrots and tomatoes, banana, watermelon/papaya/cantaloupe were all inversely and significantly related with breast cancer risk. An inverse association was also observed for vitamin A, carotene, vitamin C, vitamin E, and fiber intake. These data indicate that greater intake of vegetables and fruits is associated with a decreased risk of breast cancer among Chinese women residing in Guangdong. © 2009 UICC     

Prospective study of coffee consumption and the risk of cancer

Information on coffee consumption was obtained from 7,355 men clinically examined from 1965 to 1968, as part of a prospective cohort study. Since examination, the following numbers of newly diagnosed cancer cases have been identified: 110 lung, 108 colon, 108 prostate, 106 stomach, 60 rectum, 39 bladder, 21 pancreas, and 120 other sites. Coffee intake did not significantly increase the risk for any of the cancers in this study. There was a slight suggestion of a positive association between heavy coffee intake and the risk for lung and urinary bladder cancer, but it could be attributed to the confounding effects of cigarette smoking among the male coffee drinkers. Overall, there was no strong evidence that coffee intake increased the risk for any of the common cancers in this study.     

上海市成人男女性身高与恶性肿瘤发病的前瞻性队列研究

目的:探讨上海市成人男女性身高与常见恶性肿瘤发生的相关性。方法:利用1996-2000年上海市女性健康队列(Shanghai women’s health study,SWHS)和2002—2006年上海市男性健康队列(Shanghai men’s health study,SMHS)基线调查资料获得身高和肿瘤相关信息,排除身高数据缺失和随访时间<1年的对象,最终女性队列74709人、男性队列61161人纳入本次数据分析对象。随访至2009年底,女性队列累积收集肿瘤病例4031例,男性队列累积收集肿瘤病例2047例。用COX回归模型估计身高与常见肿瘤的相对风险比(hazard ratio,HR)及其95%可信区间(95% confidence interval,95%CI)。结果:调整相关潜在混杂因子[如年龄、体重、体力活动、能量摄入、职业、经济收入和生理因素(仅对女性)等]后,身高每增加1个标准差单位(本研究中男、女性都为6cm),女性总肿瘤发生的HR值为1.04(95%CI:1.00～1.08),其中胃癌HR值为1.18(95%CI:1.05～1.33)、肾癌HR值为1.34(95%CI:1.06～1.70)、乳腺癌HR值为1.05(95%CI:0.99～1.12);男性总肿瘤发生的HR值为1.06(95%CI:1.00～1.11),其中肺癌HR值为1.11(95%CI:1.00～1.25)、胰腺癌HR值为1.34(95%CI:1.02～1.75)、直肠癌HR值为1.23(95%CI:1.01～1.49)、前列腺癌HR值为0.78(95%CI:0.66～0.94)。结论:身高与恶性肿瘤发病之间存在一定的联系,不同的肿瘤发生部位,其结果可能存在一定差异。     

Variety in vegetable and fruit consumption and the risk of gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition

Diets high in vegetables and fruits have been suggested to be inversely associated with risk of gastric cancer. However, the evidence of the effect of variety of consumption is limited. We therefore investigated whether consumption of a variety of vegetables and fruit is associated with gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition study. Data on food consumption and follow-up on cancer incidence were available for 452,269 participants from 10 European countries. After a mean follow-up of 8.4 years, 475 cases of gastric and esophageal adenocarcinomas (180 noncardia, 185 cardia, gastric esophageal junction and esophagus, 110 not specified) and 98 esophageal squamous cell carcinomas were observed. Diet Diversity Scores were used to quantify the variety in vegetable and fruit consumption. We used multivariable Cox proportional hazard models to calculate risk ratios. Independent from quantity of consumption, variety in the consumption of vegetables and fruit combined and of fruit consumption alone were statistically significantly inversely associated with the risk of esophageal squamous cell carcinoma (continuous hazard ratio per 2 products increment 0.88; 95% CI 0.79-0.97 and 0.76; 95% CI 0.62-0.94, respectively) with the latter particularly seen in ever smokers. Variety in vegetable and/or fruit consumption was not associated with risk of gastric and esophageal adenocarcinomas. Independent from quantity of consumption, more variety in vegetable and fruit consumption combined and in fruit consumption alone may decrease the risk of esophageal squamous cell carcinoma. However, residual confounding by lifestyle factors cannot be excluded.     

Meat consumption and pancreatic cancer risk among men and women in the Cancer Prevention Study-II Nutrition Cohort

Purpose

Prospective cohort studies suggest that red and processed meat consumption is associated with increased risk of pancreatic cancer among men, but not women. However, evidence is limited, and less evidence exists for other types of meat.

Methods

Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) for the association of meat consumption, by type, with pancreatic cancer risk among 138,266 men and women in the Cancer Prevention Study-II Nutrition Cohort. Diet was assessed at baseline in 1992, and 10 years earlier, at enrollment into the parent CPS-II mortality cohort. 1,156 pancreatic cancers were verified through 2013.

Results

Red meat, processed meat, and fish intake at baseline were not associated with pancreatic cancer risk. However, for long-term red and processed meat consumption (highest quartiles in 1982 and 1992, vs. lowest quartiles), risk appeared different in men [hazard ratio (HR) 1.32, 95% confidence interval (CI) 0.90, 1.95] and women (HR 0.72, 95% CI 0.47, 1.10, p heterogeneity by sex?=?0.05). Poultry consumption in 1992 was associated with increased pancreatic cancer risk (HR 1.27, 95% CI 1.04, 1.55, p trend?=?0.01, top vs. bottom quintile).

Conclusions

The associations of meat consumption with pancreatic cancer risk remain unclear and further research, particularly of long-term intake, is warranted.

     

No association between fruit or vegetable consumption and the risk of colorectal cancer in Japan

In a pooled analysis of two prospective studies with 88,658 Japanese men and women, fruit and vegetable consumptions, were not associated with a lower risk of colorectal cancer (705 cases); multivariate relative risk (95% confidence interval) for the highest vs the lowest quartile of intake being 0.92 (0.70-1.19) and 1.00 (0.79-1.27), respectively.     

Lung cancer risk and red meat consumption among Iowa women

OBJECTIVE: Some epidemiologic studies suggest that diets high in total fat, saturated fat, or cholesterol are associated with increased risk of lung cancer. Others suggest that diets high in red meat consumption, particularly well-done red meat, are a lung cancer risk factor. In Iowa, we had the opportunity to investigate concurrently the role of meat intake and macronutrients in lung cancer etiology. METHODS: A population-based case-control study of both non-smoking and smoking women was conducted in Iowa. A 70-item food frequency questionnaire (FFQ) was completed by 360 cases and 574 frequency-matched controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression. Multivariate models included age, education, pack-years of smoking, yellow-green vegetable intake, fruit/fruit juice intake, nutrient density calories, previous non-malignant lung disease, alcohol consumption and body mass index (BMI). RESULTS: When comparing the fifth (highest) to the first (lowest) quintile of consumption of total fat, saturated fat and cholesterol, we obtained odds ratios of 2.0 (1.3-3.1), 3.0 (1.9-4.7), and 2.0 (1.3-3.0) respectively. However, when red meat was entered into the model along with total fat, saturated fat or cholesterol, the excess risk for the macronutrients disappeared while an odds ratio of 3.3 (1.7-7.6) was obtained for red meat. The odds ratios for red meat consumption were similar among adenocarcinoma cases, OR=3.0 (1.1-7.9) and non-adenocarcinoma cases, OR=3.2 (1.3-8.3) and among life-time nonsmokers and ex-smokers OR=2.8 (1.4-5.4), and current smokers, OR=4.9 (1.1-22.3). Yellow-green vegetables were protective with an odds ratio of 0.4 (0.2-0.7). CONCLUSIONS: Consumption of red meat, was associated with an increased risk of lung cancer even after controlling for total fat, saturated fat, cholesterol, fruit, yellow-green vegetable consumption and smoking history, while yellow-green vegetables are associated with a decreased risk of lung cancer.     

Vegetable and fruit consumption and cancer risk

The relationship between cancer risk and frequency of consumption of green vegetables and fruit has been analyzed using data from an integrated series of case-control studies conducted in northern Italy between 1983 and 1990. The overall dataset included the following histologically confirmed cancers: oral cavity and pharynx, 119; oesophagus, 294; stomach, 564; colon, 673; rectum, 406; liver, 258; gall-bladder, 41; pancreas, 303; larynx, 149; breast, 2,860; endometrium, 567; ovary, 742; prostate, 107; bladder, 365; kidney, 147; thyroid, 120; Hodgkin's disease, 72; non-Hodgkin lymphomas, 173; myelomas, 117; and a total of 6,147 controls admitted to hospital for acute non-neoplastic conditions, unrelated to long-term dietary modifications. Multivariate relative risks (RR) for subsequent tertiles of vegetable and fruit consumption were derived after allowance for age, sex, area of residence, education and smoking. For vegetables, there was a consistent pattern of protection for all epithelial cancers, with RRs in the upper tertile ranging from 0.2 for oesophagus, liver and larynx to 0.7 for breast. All the trends in risk were in the same direction and significant for all carcinomas except gall-bladder. In contrast, no protection was afforded by high vegetable consumption against non-epithelial lymphoid neoplasms. With reference to fruit, strong inverse relationships were observed for cancers of the upper digestive and respiratory tract, with RRs in the upper tertile between 0.2 and 0.3 for oral cavity and pharynx, oesophagus and larynx relative to the lowest tertile. The lower the location of the tumour in the digestive tract, the weaker appeared to be the protection afforded. Significant inverse relationships were observed for liver, pancreas, prostate and urinary sites, but not for rectum, breast and female genital cancers or thyroid. No relationship emerged for lymphomas and myelomas. Even in the absence of a clear biological interpretation, the consistency and strength of the patterns observed indicate that, in this population, frequent green vegetable intake is associated with a substantial reduction of risk for several common epithelial cancers, and that fruit intake has a favourable effect, especially on upper digestive cancers and, probably, also on urinary tract neoplasms.     

Dietary habits and lung cancer risk among Polish women

The purpose of this case-control study was to examine the effect of usual diet, in relation to other risk factors, on the risk of different histologic types of lung cancer in women. A total of 242 women with histologically confirmed primary lung cancer and 352 healthy controls were enrolled in a study conducted in Cracow between 1991 and 1997. A multivariate analysis showed that frequent consumption of carrots (at least five times a week) significantly lowered the risk of lung cancer. The protective effects of carrots were statistically significant for squamous cell carcinoma, small cell carcinoma and adenocarcinoma. It was found that daily consumption of other vegetables had a significant protective effect against squamous cell carcinoma, and for all histologic types combined. Furthermore, a significantly reduced risk was observed in women who consumed margarine (at least three times a week). This effect was observed for all cell types. The results also suggest that frequent consumption of carrots and frequent consumption of margarine can have a protective influence against lung cancer irrespective of the number of cigarettes smoked and the amount of vodka drunk.