Consumption of vegetables and fruit and the risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition.
Previous epidemiologic studies found inconsistent associations between vegetables and fruit consumption and the risk of bladder cancer. We therefore investigated the association between vegetable and fruit consumption and the risk of bladder cancer among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Data on food consumption and complete follow-up for cancer occurrence was available for a total of 478,533 participants, who were recruited in 10 European countries. Estimates of rate ratios were obtained by Cox proportional hazard models, stratified by age at recruitment, gender and study centre, and adjusted for total energy intake, smoking status, duration of smoking and lifetime intensity of smoking. A calibration study in a subsample was used to control for dietary measurement errors. After a mean follow-up of 8.7 years, 1015 participants were newly diagnosed with bladder cancer. Increments of 100 g/day in fruit and vegetable consumption combined did not affect bladder cancer risk (i.e., calibrated HR = 0.98; 95%CI: 0.95-1.01). Borderline statistically significant lower bladder cancer risks were found among never smokers with increased consumption of fruit and vegetables combined (HR = 0.94 95%CI: 0.87-1.00 with increments of 100 g/day; calibrated HR = 0.92 95%CI 0.79-1.06) and increased consumption of apples and pears (hard fruit; calibrated HR = 0.90 95%CI: 0.82-0.98 with increments of 25 g/day). For none of the associations a statistically significant interaction with smoking status was found. Our findings do not support an effect of fruit and vegetable consumption, combined or separately, on bladder cancer risk.
Büchner
Frederike L
FL
The National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Bueno-de-Mesquita
H Bas
HB
Ros
Martine M
MM
Kampman
Ellen
E
Egevad
Lars
L
Overvad
Kim
K
Raaschou-Nielsen
Ole
O
Tjønneland
Anne
A
Roswall
Nina
N
Clavel-Chapelon
Francoise
F
Boutron-Ruault
Marie-Christine
MC
Touillaud
Marina
M
Chang-Claude
Jenny
J
Kaaks
Rudolf
R
Boeing
Heiner
H
Weikert
Steffen
S
Trichopoulou
Antonia
A
Lagiou
Pagona
P
Trichopoulos
Dimitrios
D
Palli
Domenico
D
Sieri
Sabina
S
Vineis
Paolo
P
Tumino
Rosario
R
Panico
Salvatore
S
Vrieling
Alina
A
Peeters
Petra H M
PH
van Gils
Carla H
CH
Lund
Eiliv
E
Gram
Inger T
IT
Engeset
Dagrun
D
Martinez
Carmen
C
Gonzalez
Carlos A
CA
Larrañaga
Nerea
N
Ardanaz
Eva
E
Navarro
Carmen
C
Rodríguez
Laudina
L
Manjer
Jonas
J
Ehrnström
Roy A
RA
Hallmans
Goran
G
Ljungberg
Borje
B
Allen
Naomi E
NE
Roddam
Andrew W
AW
Bingham
Sheila
S
Khaw
Kay-Tee
KT
Slimani
Nadia
N
Boffetta
Paolo
P
Jenab
Mazda
M
Mouw
Traci
T
Michaud
Dominique S
DS
Kiemeney
Lambertus A L M
LA
Riboli
Elio
E
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D014675:Vegetables