title: Fruit and vegetable consumption and lung cancer risk: updated information from the European Prospective Investigation into Cancer and Nutrition (EPIC).
abstract: The association of fruit and vegetable consumption and lung cancer incidence was evaluated using the most recent data from the European Prospective Investigation into Cancer and Nutrition (EPIC), applying a refined statistical approach (calibration) to account for measurement error potentially introduced by using food frequency questionnaire data. Between 1992 and 2000, detailed information on diet and life-style of 478,590 individuals participating in EPIC was collected. During a median follow-up of 6.4 years, 1,126 lung cancer cases were observed. Multivariate Cox proportional hazard models were applied for statistical evaluation. In the whole study population, fruit consumption was significantly inversely associated with lung cancer risk while no association was found for vegetable consumption. In current smokers, however, lung cancer risk significantly decreased with higher vegetable consumption; this association became more pronounced after calibration, the hazard ratio (HR) being 0.78 (95% CI 0.62-0.98) per 100 g increase in daily vegetable consumption. In comparison, the HR per 100 g fruit was 0.92 (0.85-0.99) in the entire cohort and 0.90 (0.81-0.99) in smokers. Exclusion of cases diagnosed during the first 2 years of follow-up strengthened these associations, the HR being 0.71 (0.55-0.94) for vegetables (smokers) and 0.86 (0.78-0.95) for fruit (entire cohort). Cancer incidence decreased with higher consumption of apples and pears (entire cohort) as well as root vegetables (smokers). In addition to an overall inverse association with fruit intake, the results of this evaluation add evidence for a significant inverse association of vegetable consumption and lung cancer incidence in smokers.
authors.affiliation: Division of Clinical Epidemiology, German Cancer Research Centre, Heidelberg, Germany.
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authors.lastname: Linseisen
authors.forename: Sabine
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authors.lastname: Rohrmann
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Miller
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authors.lastname: Bueno-de-Mesquita
authors.forename: Frederike L
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authors.lastname: Büchner
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authors.forename: Torgny
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authors.lastname: Rasmuson
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authors.lastname: Schulz
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authors.lastname: Nieters
authors.forename: Naomi E
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authors.lastname: Key
authors.forename: Sheila
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authors.lastname: Bingham
authors.forename: Kay-Tee
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authors.lastname: Khaw
authors.forename: Pilar
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authors.lastname: Amiano
authors.forename: Aurelio
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authors.lastname: Barricarte
authors.forename: Carmen
authors.initials: C
authors.lastname: Martinez
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: Ramón
authors.initials: R
authors.lastname: Quirós
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Mathilde
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authors.lastname: Touvier
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Göran
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authors.lastname: Berglund
authors.forename: Göran
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authors.lastname: Hallmans
authors.forename: Eiliv
authors.initials: E
authors.lastname: Lund
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Anja
authors.initials: A
authors.lastname: Olsen
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Trichopoulos
authors.forename: Philippe
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authors.lastname: Autier
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Nadia
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authors.lastname: Slimani
authors.forename: Elio
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authors.lastname: Riboli
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005638:Fruit; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D014675:Vegetables