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Fruit, vegetables, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition

van Duijnhoven, Fraenzel J. B.; Bueno-De-Mesquita, H. Bas; Ferrari, Pietro; Jenab, Mazda; Boshuizen, Hendriek C.; Ros, Martine M.; Casagrande, Corinne; Tjonneland, Anne; Olsen, Anja and Overvad, Kim, et al. (2009) In American Journal of Clinical Nutrition 89(5). p.1441-1452
Abstract
Background: A high consumption of fruit and vegetables is possibly associated with a decreased risk of colorectal cancer (CRC). However, the findings to date are inconsistent. Objective: We examined the relation between self-reported usual consumption of fruit and vegetables and the incidence of CRC. Design: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 452,755 subjects (131,985 men and 320,770 women) completed a dietary questionnaire in 1992-2000 and were followed up for cancer incidence and mortality until 2006. A multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HRs) and 95% CIs. Results: After an average follow-up of 8.8 y, 2,819 incident CRC cases were reported.... (More)
Background: A high consumption of fruit and vegetables is possibly associated with a decreased risk of colorectal cancer (CRC). However, the findings to date are inconsistent. Objective: We examined the relation between self-reported usual consumption of fruit and vegetables and the incidence of CRC. Design: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 452,755 subjects (131,985 men and 320,770 women) completed a dietary questionnaire in 1992-2000 and were followed up for cancer incidence and mortality until 2006. A multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HRs) and 95% CIs. Results: After an average follow-up of 8.8 y, 2,819 incident CRC cases were reported. Consumption of fruit and vegetables was inversely associated with CRC in a comparison of the highest with the lowest EPIC-wide quintile of consumption (HR: 0.86; 95% CI: 0.75, 1.00; P for trend 0.04), particularly with colon cancer risk (HR: 0.76; 95% CI: 0.63, 0.91; P for trend < 0.01). Only after exclusion of the first 2 y of follow-up were these findings corroborated by calibrated continuous analyses for a 100-g increase in consumption: HRs of 0.95 (95% CI: 0.91, 1.00; P 0.04) and 0.94 (95% CI: 0.89, 0.99; P = 0.02), respectively. The association between fruit and vegetable consumption and CRC risk was inverse in never and former smokers, but positive in current smokers. This modifying effect was found for fruit and vegetables combined and for vegetables alone (P for interaction, 0.01 for both). Conclusions: These findings suggest that a high consumption of fruit and vegetables is associated with a reduced risk of CRC, especially of colon cancer. This effect may depend on smoking status. Am J Clin Nutr 2009;89:1441-52. (Less)
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American Journal of Clinical Nutrition
volume
89
issue
5
pages
1441 - 1452
publisher
American Society for Clinical Nutrition
external identifiers
  • wos:000265394300023
  • scopus:65549102911
ISSN
1938-3207
DOI
10.3945/ajcn.2008.27120
language
English
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yes
id
15fc149d-fc08-46e1-823a-ae2644612120 (old id 1399602)
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2009-06-15 15:04:42
date last changed
2017-12-10 04:07:42
@article{15fc149d-fc08-46e1-823a-ae2644612120,
  abstract     = {Background: A high consumption of fruit and vegetables is possibly associated with a decreased risk of colorectal cancer (CRC). However, the findings to date are inconsistent. Objective: We examined the relation between self-reported usual consumption of fruit and vegetables and the incidence of CRC. Design: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 452,755 subjects (131,985 men and 320,770 women) completed a dietary questionnaire in 1992-2000 and were followed up for cancer incidence and mortality until 2006. A multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HRs) and 95% CIs. Results: After an average follow-up of 8.8 y, 2,819 incident CRC cases were reported. Consumption of fruit and vegetables was inversely associated with CRC in a comparison of the highest with the lowest EPIC-wide quintile of consumption (HR: 0.86; 95% CI: 0.75, 1.00; P for trend 0.04), particularly with colon cancer risk (HR: 0.76; 95% CI: 0.63, 0.91; P for trend &lt; 0.01). Only after exclusion of the first 2 y of follow-up were these findings corroborated by calibrated continuous analyses for a 100-g increase in consumption: HRs of 0.95 (95% CI: 0.91, 1.00; P 0.04) and 0.94 (95% CI: 0.89, 0.99; P = 0.02), respectively. The association between fruit and vegetable consumption and CRC risk was inverse in never and former smokers, but positive in current smokers. This modifying effect was found for fruit and vegetables combined and for vegetables alone (P for interaction, 0.01 for both). Conclusions: These findings suggest that a high consumption of fruit and vegetables is associated with a reduced risk of CRC, especially of colon cancer. This effect may depend on smoking status. Am J Clin Nutr 2009;89:1441-52.},
  author       = {van Duijnhoven, Fraenzel J. B. and Bueno-De-Mesquita, H. Bas and Ferrari, Pietro and Jenab, Mazda and Boshuizen, Hendriek C. and Ros, Martine M. and Casagrande, Corinne and Tjonneland, Anne and Olsen, Anja and Overvad, Kim and Thorlacius-Ussing, Ole and Clavel-Chapelon, Francoise and Boutron-Ruault, Marie-Christine and Morois, Sophie and Kaaks, Rudolf and Linseisen, Jakob and Boeing, Heiner and Noethlings, Ute and Trichopoulou, Antonia and Trichopoulos, Dimitrios and Misirli, Gesthimani and Palli, Domenico and Sieri, Sabina and Panico, Salvatore and Tumino, Rosario and Vineis, Paolo and Peeters, Petra H. M. and van Gils, Carla H. and Ocke, Marga C. and Lund, Eiliv and Engeset, Dagrun and Skeie, Guri and Rodriguez Suarez, Laudina and Gonzalez, Carlos A. and Sanchez, Maria-Jose and Dorronsoro, Miren and Navarro, Carmen and Barricarte, Aurelio and Berglund, Göran and Manjer, Jonas and Hallmans, Goran and Palmqvist, Richard and Bingham, Sheila A. and Khaw, Kay-Tee and Key, Timothy J. and Allen, Naomi E. and Boffetta, Paolo and Slimani, Nadia and Rinaldi, Sabina and Gallo, Valentina and Norat, Teresa and Riboli, Elio},
  issn         = {1938-3207},
  language     = {eng},
  number       = {5},
  pages        = {1441--1452},
  publisher    = {American Society for Clinical Nutrition},
  series       = {American Journal of Clinical Nutrition},
  title        = {Fruit, vegetables, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition},
  url          = {http://dx.doi.org/10.3945/ajcn.2008.27120},
  volume       = {89},
  year         = {2009},
}