Subtypes of fruit and vegetables, variety in consumption and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition
File(s)150420 Leenders IJC.docx (82.74 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
Previously, a lower risk of colorectal cancer was observed with fruit and vegetable consumption in the European Prospective Investigation into Cancer and Nutrition within a follow-up period of 9 years which was not fully supported by a recent meta-analysis. Therefore, we were interested in the relation with extended follow-up, also focusing on single subtypes and a variety of intake of fruit and vegetables. Fruit and vegetable consumption was assessed at baseline. After an average of 13 years of follow-up, 3,370 participants were diagnosed with colon or rectal cancer. Diet diversity scores were constructed to quantify variety in fruit and vegetable consumption. A lower risk of colon cancer was observed with higher self-reported consumption of fruit and vegetable combined (HR Q4 vs. Q1 0.87, 95% CI 0.75–1.01, p for trend 0.02), but no consistent association was observed for separate consumption of fruits and vegetables. No associations with risk of rectal cancer were observed. The few observed associations for some fruit and vegetable subtypes with colon cancer risk may have been due to chance. Variety in consumption of fruits and vegetables was not associated with a lower risk of colon or rectal cancer. Although a lower risk of colon cancer is suggested with high consumption of fruit and vegetables, this study does not support a clear inverse association between fruit and vegetable consumption and colon or rectal cancer beyond a follow-up of more than 10 years. Attenuation of the risk estimates from dietary changes over time cannot be excluded, but appears unlikely.
Date Issued
2015-06-15
Date Acceptance
2015-04-20
Citation
International Journal of Cancer, 2015, 137 (11), pp.2705-2714
ISSN
1097-0215
Publisher
Wiley
Start Page
2705
End Page
2714
Journal / Book Title
International Journal of Cancer
Volume
137
Issue
11
Copyright Statement
© 2015 UICC. This is the accepted version of the following article: Leenders, M., Siersema, P. D., Overvad, K., Tjønneland, A., Olsen, A., Boutron-Ruault, M.-C., Bastide, N., Fagherazzi, G., Katzke, V., Kühn, T., Boeing, H., Aleksandrova, K., Trichopoulou, A., Lagiou, P., Klinaki, E., Masala, G., Grioni, S., Santucci De Magistris, M., Tumino, R., Ricceri, F., Peeters, P. H.M., Lund, E., Skeie, G., Weiderpass, E., Quirós, J. R., Agudo, A., Sánchez, M.-J., Dorronsoro, M., Navarro, C., Ardanaz, E., Ohlsson, B., Jirström, K., Van Guelpen, B., Wennberg, M., Khaw, K.-T., Wareham, N., Key, T. J., Romieu, I., Huybrechts, I., Cross, A. J., Murphy, N., Riboli, E. and Bueno-de-Mesquita, H. (2015), Subtypes of fruit and vegetables, variety in consumption and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition. Int. J. Cancer, 137: 2705–2714, which has been published in final form at http://dx.doi.org/10.1002/ijc.29640.
Sponsor
Imperial College Trust
Grant Number
P47328
Subjects
Science & Technology
Life Sciences & Biomedicine
Oncology
fruits and vegetables
colorectal cancer
variety
COLORECTAL-CANCER
DIET DIVERSITY
CRUCIFEROUS VEGETABLES
COHORT
MUSHROOMS
JAPAN
Adult
Colorectal Neoplasms
Diet
Europe
Female
Food Habits
Fruit
Humans
Male
Middle Aged
Nutritional Status
Prospective Studies
Risk
Risk Factors
Vegetables
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status
Published