Association of vegetable, fruit, and grain intakes with colorectal cancer: the Multiethnic Cohort Study.
BACKGROUND
It is uncertain whether or not vegetables, fruit, or grains protect against colorectal cancer.


OBJECTIVE
In a large prospective study, we investigated the association of vegetable, fruit, and grain intakes with colorectal cancer risk.


METHODS
Between 1993 and 1996, 85 903 men and 105 108 women completed a quantitative food-frequency questionnaire that included approximately 180 foods and beverages in the Multiethnic Cohort Study. A diagnosis of colorectal cancer was made in 1138 men and 972 women after an average follow-up of 7.3 y. Cox proportional hazards models were used to calculate multivariate-adjusted relative risks and 95% CIs for colorectal cancer.


RESULTS
In men, multivariate adjustment for energy intake, dietary, and nondietary variables resulted in relative risks in the highest quintile group of 0.74 (95% CI: 0.59, 0.93; P for trend = 0.02) for vegetables and fruit combined, 0.80 (95% CI: 0.64, 0.99; P for trend = 0.09) for fruit alone, and 0.85 (95% CI: 0.69, 1.05; P for trend = 0.05) for vegetables alone. When colon and rectal cases were separated among men, the inverse associations were stronger for colon than for rectal cancer. In women, none of the associations with vegetables, fruit, or vegetables and fruit combined were significant. Grain intake was not associated with colorectal cancer for either men or women.


CONCLUSIONS
The intake of vegetables and fruit was inversely related to colorectal cancer risk among men but not among women. The association appears stronger for colon than for rectal cancer.
Nomura
Abraham M Y
AM
Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI 96813, USA. abe@crch.hawaii.edu
Wilkens
Lynne R
LR
Murphy
Suzanne P
SP
Hankin
Jean H
JH
Henderson
Brian E
BE
Pike
Malcolm C
MC
Kolonel
Laurence N
LN
D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D002523:Edible Grain; D005260:Female; D005638:Fruit; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D016016:Proportional Hazards Models; D012727:Sex Characteristics; D014675:Vegetables
Cancer Causes Control. 2007 Sep;18(7):753-64
17557210
Am J Epidemiol. 1994 Jan 1;139(1):1-15
8296768
J Natl Cancer Inst. 1992 Oct 7;84(19):1491-500
1433333
N Engl J Med. 2004 Mar 4;350(10):991-1004
14999111
Am J Epidemiol. 2003 Jul 1;158(1):14-21; discussion 22-6
12835281
Am J Epidemiol. 2000 Dec 1;152(11):1081-92
11117618
Am J Clin Nutr. 2007 May;85(5):1353-60
17490973
Cancer Causes Control. 2003 Dec;14(10):959-70
14750535
Am J Epidemiol. 2000 Feb 15;151(4):346-57
10695593
Am J Epidemiol. 2000 Feb 15;151(4):358-70
10695594
Cancer. 1995 Dec 1;76(11):2343-50
8635041
J Natl Cancer Inst. 2000 Nov 1;92(21):1740-52
11058617
J Natl Cancer Inst. 1995 Apr 5;87(7):517-23
7707438
Br J Cancer. 2005 May 9;92(9):1782-4
15856039
Cancer Causes Control. 2005 Apr;16(3):225-33
15947874
Am J Epidemiol. 2007 Jul 15;166(2):170-80
17485731
Eur J Clin Nutr. 1995 Jun;49(6):420-9
7656885
Am J Epidemiol. 2003 Jul 1;158(1):1-13
12835280
Cancer Causes Control. 1999 Oct;10(5):387-96
10530608
Epidemiology. 1996 Mar;7(2):161-5
8834556
J Natl Cancer Inst. 2001 Apr 4;93(7):525-33
11287446
J Natl Cancer Inst. 1985 Aug;75(2):185-91
3894750
Cancer Causes Control. 1991 Nov;2(6):427-42
1764568
Am J Clin Nutr. 2006 Feb;83(2):343-9
16469993
Am J Clin Nutr. 2002 May;75(5):936-43
11976170