Print Email Facebook Twitter Fruits, vegetables, and colon cancer risk in a pooled analysis of 14 cohort studies Title Fruits, vegetables, and colon cancer risk in a pooled analysis of 14 cohort studies Author Koushik, A. Hunter, D.J. Spiegelman, D. Beeson, W.L. van den Brandt, P.A. Buring, J.E. Calle, E.E. Cho, E. Fraser, G.E. Freudenheim, J.L. Fuchs, C.S. Giovannucci, E.L. Goldbohm, R.A. Harnack, L. Jacobs Jr., D.R. Kato, I. Krogh, V. Larsson, S.C. Leitzmann, M.F. Marshall, J.R. McCullough, M.L. Miller, A.B. Pietinen, P. Rohan, T.E. Schatzkin, A. Sieri, S. Virtanen, M.J. Wolk, A. Zeleniuch-Jacquotte, A. Zhang, S.M. Smith-Warner, S.A. TNO Kwaliteit van Leven Publication year 2007 Abstract Background Fruit and vegetable intakes have been associated with a reduced risk of colon cancer; however, in more recent studies associations have been less consistent. Statistical power to examine associations by colon site has been limited in previous studies. Methods Fruit and vegetable intakes in relation to colon cancer risk were examined in the Pooling Project of Prospective Studies of Diet and Cancer. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated separately in 14 studies using Cox proportional hazards model and then pooled using a random- effects model. Intakes of total fruits and vegetables, total fruits, and total vegetables were categorized according to quintiles and absolute cutpoints. Analyses were conducted for colon cancer overall and for proximal and distal colon cancer separately. All statistical tests were two-sided. Results Among 756 217 men and women followed for up to 6 to 20 years, depending on the study, 5838 were diagnosed with colon cancer. The pooled multivariable RRs (95% CIs) of colon cancer for the highest versus lowest quintiles of intake were 0.91 (0.82 to 1.01, Ptrend =.19) for total fruits and vegetables, 0.93 (0.85 to 1.02, Ptrend =.28) for total fruits, and 0.94 (0.86 to 1.02, P trend =.17) for total vegetables. Similar results were observed when intakes were categorized by identical absolute cut points across studies (pooled multivariable RR = 0.90, 95% CI = 0.77 to 1.05 for 800 or more versus <200 g/day of total fruits and vegetables, Ptrend =.06). The age-standardized incidence rates of colon cancer for these two intake categories were 54 and 61 per 100 000 person-years, respectively. When analyzed by colon site, the pooled multivari- able RRs (95% CIs) comparing total fruit and vegetable intakes of 800 or more versus less than 200 g/day were 0.74 (0.57 to 0.95, Ptrend =.02) for distal colon cancers and 1.02 (0.82 to 1.27, Ptrend =.57) for proximal colon cancers. Similar site-specific associations were observed for total fruits and total vegetables. Conclusion Fruit and vegetable intakes were not strongly associated with colon cancer risk overall but may be associated with a lower risk of distal colon cancer. Subject NutritionFood and Chemical Risk Analysisadultagedanatomical variationarticleascending coloncancer incidencecancer riskcohort analysiscolon cancerdescending colondisease associationfemalefollow upfood intakefruithumanmajor clinical studymalepriority journalrisk assessmentvegetableclinical trialcolon tumorEuropefeeding behaviormeta analysismiddle agedmultivariate analysisNorth Americaprospective studyriskrisk factorrisk reductionAdultAgedColonic NeoplasmsEuropeFemaleFood HabitsFruitHumansMaleMiddle AgedMultivariate AnalysisNorth AmericaOdds RatioProspective StudiesRisk AssessmentRisk FactorsRisk Reduction BehaviorVegetables To reference this document use: http://resolver.tudelft.nl/uuid:a09580b7-1f9f-427b-946f-1d27a7c349a2 DOI https://doi.org/10.1093/jnci/djm155 TNO identifier 240224 ISSN 0027-8874 Source Journal of the National Cancer Institute, 99 (19), 1471-1483 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.