Fruit and vegetable consumption and lung cancer risk: Updated information from the European Prospective Investigation into Cancer and Nutrition (EPIC)

Jakob Linseisen, Sabine Rohrmann, Anthony B. Miller, H. Bas Bueno-De-Mesquita, Frederike L. Büchner, Paolo Vineis, Antonio Agudo, Inger T. Gram, Lars Janson, Vittorio Krogh, Kim Overvad, Torgny Rasmuson, Mandy Schulz, Tobias Pischon, Rudolf Kaaks, Alexandra Nieters, Naomi E. Allen, Timothy J. Key, Sheila Bingham, Kay Tee KhawPilar Amiano, Aurelio Barricarte, Carmen Martinez, Carmen Navarro, Ramón Quirós, Françoise Clavel-Chapelon, Marie Christine Boutron-Ruault, Mathilde Touvier, Petra H M Peeters, Göran Berglund, Göran Hallmans, Eiliv Lund, Domenico Palli, Salvatore Panico, Rosario Tumino, Anne Tjønneland, Anja Olsen, Antonia Trichopoulou, Dimitrios Trichopoulos, Philippe Autier, Paolo Boffetta, Nadia Slimani, Elio Riboli

Research output: Contribution to journalArticle

Abstract

The association of fruit and vegetable consumption and lung cancer incidence was evaluated using the most recent data from the European Prospective Investigation into Cancer and Nutrition (EPIC), applying a refined statistical approach (calibration) to account for measurement error potentially introduced by using food frequency questionnaire data. Between 1992 and 2000, detailed information on diet and life-style of 478,590 individuals participating in EPIC was collected. During a median follow-up of 6.4 years, 1,126 lung cancer cases were observed. Multivariate Cox proportional hazard models were applied for statistical evaluation. In the whole study population, fruit consumption was significantly inversely associated with lung cancer risk while no association was found for vegetable consumption. In current smokers, however, lung cancer risk significantly decreased with higher vegetable consumption; this association became more pronounced after calibration, the hazard ratio (HR) being 0.78 (95% CI 0.62-0.98) per 100 g increase in daily vegetable consumption. In comparison, the HR per 100 g fruit was 0.92 (0.85-0.99) in the entire cohort and 0.90 (0.81-0.99) in smokers. Exclusion of cases diagnosed during the first 2 years of follow-up strengthened these associations, the HR being 0.71 (0.55-0.94) for vegetables (smokers) and 0.86 (0.78-0.95) for fruit (entire cohort). Cancer incidence decreased with higher consumption of apples and pears (entire cohort) as well as root vegetables (smokers). In addition to an overall inverse association with fruit intake, the results of this evaluation add evidence for a significant inverse association of vegetable consumption and lung cancer incidence in smokers.

Original languageEnglish
Pages (from-to)1103-1114
Number of pages12
JournalInternational Journal of Cancer
Volume121
Issue number5
DOIs
Publication statusPublished - Sep 1 2007

Keywords

  • Cancer
  • Diet
  • Epidemiology
  • Fruit
  • Lung cancer
  • Smoking
  • Vegetables

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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  • Cite this

    Linseisen, J., Rohrmann, S., Miller, A. B., Bueno-De-Mesquita, H. B., Büchner, F. L., Vineis, P., Agudo, A., Gram, I. T., Janson, L., Krogh, V., Overvad, K., Rasmuson, T., Schulz, M., Pischon, T., Kaaks, R., Nieters, A., Allen, N. E., Key, T. J., Bingham, S., ... Riboli, E. (2007). Fruit and vegetable consumption and lung cancer risk: Updated information from the European Prospective Investigation into Cancer and Nutrition (EPIC). International Journal of Cancer, 121(5), 1103-1114. https://doi.org/10.1002/ijc.22807