Title
Fruits, vegetables and lung cancer: A pooled analysis of cohort studies
Author
Smith-Warner, S.A.
Spiegelman, D.
Yaun, S.-S.
Albanes, D.
Beeson, W.L.
van den Brandt, P.A.
Feskanich, D.
Folsom, A.R.
Fraser, G.E.
Freudenheim, J.L.
Giovannucci, E.
Goldbohm, R.A.
Graham, S.
Kushi, L.H.
Miller, A.B.
Pietinen, P.
Rohan, T.E.
Speizer, F.E.
Willett, W.C.
Hunter, D.J.
Publication year
2003
Abstract
Inverse associations between fruit and vegetable consumption and lung cancer risk have been consistently reported. However, identifying the specific fruits and vegetables associated with lung cancer is difficult because the food groups and foods evaluated have varied across studies. We analyzed fruit and vegetable groups using standardized exposure and covariate definitions in 8 prospective studies. We combined study-specific relative risks (RRs) using a random effects model. In the pooled database, 3,206 incident lung cancer cases occurred among 430,281 women and men followed for up to 6-16 years across studies. Controlling for smoking habits and other lung cancer risk factors, a 16-23% reduction in lung cancer risk was observed for quintiles 2 through 5 vs. the lowest quintile of consumption for total fruits (RR = 0.77; 95% CI = 0.67-0.87 for quintile 5; p-value, test for trend < 0.001) and for total fruits and vegetables (RR = 0.79; 95% CI = 0.69-0.90; p-value, test for trend = 0.001). For the same comparison, the association was weaker for total vegetable consumption (RR = 0.88; 95% CI = 0.78-1.00; p-value, test for trend = 0.12). Associations were similar between never, past, and current smokers. These results suggest that elevated fruit and vegetable consumption is associated with a modest reduction in lung cancer risk, which is mostly attributable to fruit, not vegetable, intake. However, we cannot rule out the possibility that our results are due to residual confounding by smoking. The primary focus for reducing lung cancer incidence should continue to be smoking prevention and cessation. © 2003 Wiley-Liss, Inc.
Subject
Nutrition Health
Food and Chemical Risk Analysis
Cohort studies
Fruit
Lung neoplasms
Pooling
Vegetables
article
cancer incidence
cancer prevention
cancer risk
cohort analysis
covariance
data base
follow up
food intake
fruit
human
lung adenocarcinoma
lung cancer
lung small cell cancer
lung squamous cell carcinoma
multivariate analysis
priority journal
questionnaire
risk factor
smoking
smoking cessation
vegetable
Analysis of Variance
Cohort Studies
Female
Fruit
Humans
Lung Neoplasms
Male
Reproducibility of Results
Risk
Risk Factors
Sample Size
Smoking
Vegetables
To reference this document use:
http://resolver.tudelft.nl/uuid:cce0f633-823b-4c09-b6be-05145ccd7cd6
DOI
https://doi.org/10.1002/ijc.11490
TNO identifier
237534
ISSN
0020-7136
Source
International Journal of Cancer, 107 (6), 1001-1011
Document type
article