Variety in vegetable and fruit consumption and risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition.
Recent research does not show an association between fruit and vegetable consumption and bladder cancer risk. None of these studies investigated variety in fruit and vegetable consumption, which may capture different aspects of consumption. We investigated whether a varied consumption of vegetables and fruits is associated with bladder cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Detailed data on food consumption and complete follow-up for cancer incidence were available for 452,185 participants, who were recruited from ten European countries. After a mean follow-up of 8.7 years, 874 participants were diagnosed with bladder cancer. Diet diversity scores (DDSs) were used to quantify the variety in fruit and vegetable consumption. Multivariable Cox proportional hazard models were used to assess the effect of the DDSs on bladder cancer risk. There was no evidence of a statistically significant association between bladder cancer risk and any of the DDSs when these scores were considered as continuous covariates. However, the hazard ratio (HR) for the highest tertile of the DDS for combined fruit and vegetable consumption was marginally significant compared to the lowest (HR = 1.30, 95% confidence interval: 1.00-1.69, p-trend = 0.05). In EPIC, there is no clear association between a varied fruit and vegetable consumption and bladder cancer risk. This finding provides further evidence for the absence of any strong association between fruit and vegetable consumption as measured by a food frequency questionnaire and bladder cancer risk.
The National Institute for Public Health and the Environment, RIVM, Bilthoven, The Netherlands. frederike.buchner@rivm.nl
Frederike L
FL
Büchner
H Bas
HB
Bueno-de-Mesquita
Martine M
MM
Ros
Ellen
E
Kampman
Lars
L
Egevad
Kim
K
Overvad
Anne
A
Tjønneland
Nina
N
Roswall
Françoise
F
Clavel-Chapelon
Marie-Christine
MC
Boutron-Ruault
Marina
M
Touillaud
Rudolf
R
Kaaks
Jenny
J
Chang-Claude
Heiner
H
Boeing
Steffen
S
Weikert
Antonia
A
Trichopoulou
Ada
A
Naska
Vicky
V
Benetou
Domenico
D
Palli
Sabina
S
Sieri
Paolo
P
Vineis
Rosario
R
Tumino
Salvatore
S
Panico
Fränzel J B
FJ
van Duijnhoven
Petra H M
PH
Peeters
Carla H
CH
van Gils
Eiliv
E
Lund
Inger T
IT
Gram
Maria-José
MJ
Sánchez
Paula
P
Jakszyn
Nerea
N
Larrañaga
Eva
E
Ardanaz
Carmen
C
Navarro
Laudina
L
Rodríguez
Jonas
J
Manjer
Roy
R
Ehrnström
Göran
G
Hallmans
Börje
B
Ljungberg
Tim J
TJ
Key
Naomi E
NE
Allen
Kay-Tee
KT
Khaw
Nicholas
N
Wareham
Nadia
N
Slimani
Mazda
M
Jenab
Paolo
P
Boffetta
Lambertus A L M
LA
Kiemeney
Elio
E
Riboli
D004032:Diet; D005060:Europe; D005260:Female; D005638:Fruit; D006801:Humans; D008019:Life Style; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology*; D014675:Vegetables