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Fruit and vegetable consumption and lymphoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)
Authors:Rohrmann Sabine  Becker Nikolaus  Linseisen Jakob  Nieters Alexandra  Rüdiger Thomas  Raaschou-Nielsen Ole  Tjønneland Anne  Johnsen Hans E  Overvad Kim  Kaaks Rudolf  Bergmann Manuela M  Boeing Heiner  Benetou Vasiliki  Psaltopoulou Theodora  Trichopoulou Antonia  Masala Giovanna  Mattiello Amalia  Krogh Vittorio  Tumino Rosario  van Gils Carla H  Peeters Petra H M  Bueno-de-Mesquita H Bas  Ros Martine M  Lund Eiliv  Ardanaz Eva  Chirlaque María-Dolores  Jakszyn Paula  Larrañaga Nerea  Losada A  Martínez-García Carmen  Agren Asa  Hallmans Göran  Berglund Göran  Manjer Jonas  Allen Naomi E  Key Timothy J  Bingham Sheila
Affiliation:Division of Clinical Epidemiology (C020), German Cancer Research Centre, Im Neuenheimer Feld 280, Heidelberg, 69120, Germany. s.rohrmann@dkfz.de
Abstract:Introduction Lymphomas are a heterogeneous group of malignant diseases of cells of the immune system. The best-established risk factors are related to dys-regulation of immune function, and evidence suggests that factors such as dietary or lifestyle habits may be involved in the etiology. Material and methods In the European Prospective Investigation into Cancer and Nutrition (EPIC), 849 lymphoma cases were identified in a median follow-up period of 6.4 years. Fruit and vegetable consumption was estimated from validated dietary questionnaires. Cox proportional hazard models were used to examine the association between fruit and vegetable intake with the risk of lymphomas overall and subentities. Results There was no overall association between total fruit and vegetable consumption and risk of lymphoma [hazard ratio (HR) = 0.95, 95% confidence interval (CI) 0.78–1.15 comparing highest with lowest quartile]. However, the risk of diffuse large B-cell lymphomas (DLBCL) tended to be lower in participants with a high intake of total vegetables (HR = 0.49, 95% CI 0.23–1.02). Conclusion In this large prospective study, an inverse associations between fruit and vegetable consumption and risk of lymphomas overall could not be confirmed. Associations with lymphoma subentities such as DLBCL warrant further investigation. The work described in this article was carried out with the financial support of: Europe Against Cancer Program of the European Commission (SANCO); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucia, Asturia, Basque Country, Murcia and Navarra; the ISCIII Network RCESP (C03/09), Spain; Cancer Research UK; Medical Research Council, United Kingdom; Stroke Association, United Kingdom; British Heart Foundation; Department of Health, United Kingdom; Food Standards Agency, United Kingdom; Wellcome Trust, United Kingdom; Greek Ministry of Health; Greek Ministry of Education; Italian Association for Research on Cancer (AIRC); Italian National Research Council, Fondazione-Istituto Banco Napoli, Italy; Compagnia di San Paolo; Dutch Ministry of Public Health, Welfare and Sports; World Cancer Research Fund; Swedish Cancer Society; Swedish Scientific Council; Regional Government of Sk?ne, Sweden; Norwegian Cancer Society; Research Council of Norway; French League against Cancer (LNCC); National Institute for Health and Medical Research (INSERM), France; Mutuelle Générale de l’Education Nationale (MGEN), France; 3M Co, France; Gustave Roussy Institute (IGR), France; and General Councils of France.
Keywords:Non-Hodgkin lymphoma  Hodgkin lymphoma  Fruits  Vegetables  Cohort study
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