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
Nutrition
Food and Chemical Risk Analysis
adult
aged
anatomical variation
article
ascending colon
cancer incidence
cancer risk
cohort analysis
colon cancer
descending colon
disease association
female
follow up
food intake
fruit
human
major clinical study
male
priority journal
risk assessment
vegetable
clinical trial
colon tumor
Europe
feeding behavior
meta analysis
middle aged
multivariate analysis
North America
prospective study
risk
risk factor
risk reduction
Adult
Aged
Colonic Neoplasms
Europe
Female
Food Habits
Fruit
Humans
Male
Middle Aged
Multivariate Analysis
North America
Odds Ratio
Prospective Studies
Risk Assessment
Risk Factors
Risk Reduction Behavior
Vegetables
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