Fruit and vegetable intake and prevalence of colorectal adenoma in a cancer screening trial.
BACKGROUND
Research on the association between fruit and vegetable intake and risk of colorectal adenoma is inconclusive.


OBJECTIVE
We studied whether intake of fruit, vegetables, or their subgroups is associated with a lower risk of prevalent colorectal adenoma.


METHODS
In men and women (aged 55-74 y) who were screened for colorectal cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (1993-2001), we compared 3,057 cases with at least one prevalent histologically verified adenoma of the distal large bowel with 29,413 control subjects. Using a food-frequency questionnaire, we quantified intake of fruit and vegetables in the 12 mo before screening as energy-adjusted pyramid servings/d (ps/d). Adjusted odds ratios (ORs) and 95% CIs were estimated by logistic regression.


RESULTS
Risk of distal adenoma was significantly lower among subjects in high (approximately 5.7 ps/d) versus low (approximately 1.2 ps/d) quintiles of total fruit intake (OR: 0.75; 95% CI: 0.66, 0.86, P for trend <0.001), which was not completely explained by dietary folate or fiber intake. Inverse associations between adenoma and total fruit intake were observed regardless of adenoma histopathology and multiplicity. However, the protective effect was seen only for colon and not rectal adenoma. Total vegetable intake was not significantly associated with reduced risk of adenoma. ORs for colorectal adenoma among persons with high versus low intakes of deep-yellow vegetables, dark-green vegetables, and onions and garlic were significantly related to lower risk of adenoma, although the P for trend for dark-green vegetables was not significant.


CONCLUSIONS
Diets rich in fruit and deep-yellow vegetables, dark-green vegetables, and onions and garlic are modestly associated with reduced risk of colorectal adenoma, a precursor of colorectal cancer.
University at Buffalo, School of Public Health and Health Professions, Department of Social and Preventive Medicine, Buffalo, NY 14214-8001, USA. aemillen@buffalo.edu
Amy E
AE
Millen
Amy F
AF
Subar
Barry I
BI
Graubard
Ulrike
U
Peters
Richard B
RB
Hayes
Joel L
JL
Weissfeld
Lance A
LA
Yokochi
Regina G
RG
Ziegler
D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology*; D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D004435:Eating / Q000502:physiology; D016099:Endoscopy, Gastrointestinal; D005144:F Factor; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014675:Vegetables