title: Consumption of vegetables and fruit and the risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition.
abstract: 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.
authors.affiliation: The National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Frederike L
authors.initials: FL
authors.lastname: Büchner
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Martine M
authors.initials: MM
authors.lastname: Ros
authors.forename: Ellen
authors.initials: E
authors.lastname: Kampman
authors.forename: Lars
authors.initials: L
authors.lastname: Egevad
authors.forename: Kim
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authors.lastname: Overvad
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authors.initials: O
authors.lastname: Raaschou-Nielsen
authors.forename: Anne
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authors.lastname: Tjønneland
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authors.lastname: Roswall
authors.forename: Francoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Marina
authors.initials: M
authors.lastname: Touillaud
authors.forename: Jenny
authors.initials: J
authors.lastname: Chang-Claude
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Heiner
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authors.lastname: Boeing
authors.forename: Steffen
authors.initials: S
authors.lastname: Weikert
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Pagona
authors.initials: P
authors.lastname: Lagiou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Trichopoulos
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Sabina
authors.initials: S
authors.lastname: Sieri
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Alina
authors.initials: A
authors.lastname: Vrieling
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Carla H
authors.initials: CH
authors.lastname: van Gils
authors.forename: Eiliv
authors.initials: E
authors.lastname: Lund
authors.forename: Inger T
authors.initials: IT
authors.lastname: Gram
authors.forename: Dagrun
authors.initials: D
authors.lastname: Engeset
authors.forename: Carmen
authors.initials: C
authors.lastname: Martinez
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Gonzalez
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: Laudina
authors.initials: L
authors.lastname: Rodríguez
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.forename: Roy A
authors.initials: RA
authors.lastname: Ehrnström
authors.forename: Goran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Borje
authors.initials: B
authors.lastname: Ljungberg
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Allen
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Roddam
authors.forename: Sheila
authors.initials: S
authors.lastname: Bingham
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nadia
authors.initials: N
authors.lastname: Slimani
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Mazda
authors.initials: M
authors.lastname: Jenab
authors.forename: Traci
authors.initials: T
authors.lastname: Mouw
authors.forename: Dominique S
authors.initials: DS
authors.lastname: Michaud
authors.forename: Lambertus A L M
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authors.lastname: Kiemeney
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
mesh_terms: 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