Intake of fruits and vegetables and risk of cancer of the upper aero-digestive tract: the prospective EPIC-study.
Epidemiologic studies suggest that a high intake of fruits and vegetables is associated with decreased risk of cancers of the upper aero-digestive tract. We studied data from 345,904 subjects of the prospective European Investigation into Cancer and Nutrition (EPIC) recruited in seven European countries, who had completed a dietary questionnaire in 1992-1998. During 2,182,560 person years of observation 352 histologically verified incident squamous cell cancer (SCC) cases (255 males; 97 females) of the oral cavity, pharynx, larynx, and esophagus were identified. Linear and restricted cubic spline Cox regressions were fitted on variables of intake of fruits and vegetables and adjusted for potential confounders. We observed a significant inverse association with combined total fruits and vegetables intake (estimated relative risk (RR) = 0.91; 95% confidence interval (95% CI) 0.83-1.00 per 80 g/d of consumption), and nearly significant inverse associations in separate analyses with total fruits and total vegetables intake (RR: 0.97 (95% CI: 0.92-1.02) and RR = 0.89 (95% CI: 0.78-1.02) per 40 g/d of consumption). Overall, vegetable subgroups were not related to risk with the exception of intake of root vegetables in men. Restricted cubic spline regression did not improve the linear model fits except for total fruits and vegetables and total fruits with a significant decrease in risk at low intake levels (<120 g/d) for fruits. Dietary recommendations should consider the potential benefit of increasing fruits and vegetables consumption for reducing the risk of cancers of the upper aero-digestive tract, particularly at low intake.
Boeing
Heiner
H
Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany. boeing@mail.dife.de
Dietrich
Thomas
T
Hoffmann
Kurt
K
Pischon
Tobias
T
Ferrari
Pietro
P
Lahmann
Petra H
PH
Boutron-Ruault
Marie Christine
MC
Clavel-Chapelon
Francoise
F
Allen
Naomi
N
Key
Tim
T
Skeie
Guri
G
Lund
Eiliv
E
Olsen
Anja
A
Tjonneland
Anne
A
Overvad
Kim
K
Jensen
Majken K
MK
Rohrmann
Sabine
S
Linseisen
Jakob
J
Trichopoulou
Antonia
A
Bamia
Christina
C
Psaltopoulou
Theodora
T
Weinehall
Lars
L
Johansson
Ingegerd
I
Sánchez
Maria-José
MJ
Jakszyn
Paula
P
Ardanaz
Eva
E
Amiano
Pilar
P
Chirlaque
Maria Dolores
MD
Quirós
J Ramón
JR
Wirfalt
Elisabet
E
Berglund
Göran
G
Peeters
Petra H
PH
van Gils
Carla H
CH
Bueno-de-Mesquita
H Bas
HB
Büchner
Frederike L
FL
Berrino
Franco
F
Palli
Domenico
D
Sacerdote
Carlotta
C
Tumino
Rosario
R
Panico
Salvatore
S
Bingham
Sheila
S
Khaw
Kay-Tee
KT
Slimani
Nadia
N
Norat
Teresa
T
Jenab
Mazda
M
Riboli
Elio
E
D002294:Carcinoma, Squamous Cell / Q000517:prevention & control; D015331:Cohort Studies; D004032:Diet; D004938:Esophageal Neoplasms / Q000517:prevention & control*; D005260:Female; D005638:Fruit; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000517:prevention & control*; D008297:Male; D009062:Mouth Neoplasms / Q000517:prevention & control*; D010610:Pharyngeal Neoplasms / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors; D014675:Vegetables