Fruit and vegetable consumption and lymphoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).
BACKGROUND
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.


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).


CONCLUSIONS
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.
Rohrmann
Sabine
S
Division of Clinical Epidemiology (C020), German Cancer Research Centre, Im Neuenheimer Feld 280, Heidelberg, 69120, Germany. s.rohrmann@dkfz.de
Becker
Nikolaus
N
Linseisen
Jakob
J
Nieters
Alexandra
A
Rüdiger
Thomas
T
Raaschou-Nielsen
Ole
O
Tjønneland
Anne
A
Johnsen
Hans E
HE
Overvad
Kim
K
Kaaks
Rudolf
R
Bergmann
Manuela M
MM
Boeing
Heiner
H
Benetou
Vasiliki
V
Psaltopoulou
Theodora
T
Trichopoulou
Antonia
A
Masala
Giovanna
G
Mattiello
Amalia
A
Krogh
Vittorio
V
Tumino
Rosario
R
van Gils
Carla H
CH
Peeters
Petra H M
PH
Bueno-de-Mesquita
H Bas
HB
Ros
Martine M
MM
Lund
Eiliv
E
Ardanaz
Eva
E
Chirlaque
María-Dolores
MD
Jakszyn
Paula
P
Larrañaga
Nerea
N
Losada
A
A
Martínez-García
Carmen
C
Agren
Asa
A
Hallmans
Göran
G
Berglund
Göran
G
Manjer
Jonas
J
Allen
Naomi E
NE
Key
Timothy J
TJ
Bingham
Sheila
S
Khaw
Kay Tee
KT
Slimani
Nadia
N
Ferrari
Pietro
P
Boffetta
Paolo
P
Norat
Teresa
T
Vineis
Paolo
P
Riboli
Elio
E
D015331:Cohort Studies; D005060:Europe; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D015994:Incidence; D008223:Lymphoma / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D012307:Risk Factors; D014675:Vegetables