Variety in fruit and vegetable consumption and the risk of lung cancer in the European Prospective Investigation into Cancer and Nutrition

Frederike L. Büchner, H. Bas Bueno-de-Mesquita, Martine M. Ros, Kim Overvad, Christina C. Dahm, Louise Hansen, Anne Tjønneland, Françoise Clavel-Chapelon, Marie Christine Boutron-Ruault, Marina Touillaud, Rudolf Kaaks, Sabine Rohrmann, Heiner Boeing, Ute Nöthlings, Antonia Trichopoulou, Dimosthenis Zylis, Vardis Dilis, Domenico Palli, Sabina Sieri, Paolo VineisRosario Tumino, Salvatore Panico, Petra H M Peeters, Carla H. Van Gils, Eiliv Lund, Inger T. Gram, Tonje Braaten, María José Sánchez, Antonio Agudo, Nerea Larrañaga, Eva Ardanaz, Carmen Navarro, Marcial V. Argüelles, Jonas Manjer, Elisabet Wirfält, Göran Hallmans, Torgny Rasmuson, Tim J. Key, Kay Tee Khaw, Nick Wareham, Nadia Slimani, Anne Claire Vergnaud, Wei W. Xun, Lambertus A L M Kiemeney, Elio Riboli

Research output: Contribution to journalArticle

Abstract

Background: We investigated whether a varied consumption of vegetables and fruits is associated with lower lung cancer risk in the European Prospective Investigation into Cancer and Nutrition study. Methods: After a mean follow-up of 8.7 years, 1,613 of 452,187 participants with complete information were diagnosed with lung cancer. Diet diversity scores (DDS) were used to quantify the variety in fruit and vegetable consumption. Multivariable proportional hazards models were used to assess the associations between DDS and lung cancer risk. All modelswere adjusted for smoking behavior and the total consumption of fruit and vegetables. Results: With increasing variety in vegetable subgroups, risk of lung cancer decreases [hazard ratios (HR), 0.77; 95% confidence interval (CI), 0.64-0.94 highest versus lowest quartile; P trend = 0.02]. This inverse association is restricted to current smokers (HR, 0.73; 95% CI, 0.57-0.93 highest versus lowest quartile; P trend = 0.03). In continuous analyses, in current smokers, lower risks were observed for squamous cell carcinomas with more variety in fruit and vegetable products combined (HR/two products, 0.88; 95% CI, 0.82-0.95), vegetable subgroups (HR/subgroup, 0.88; 95% CI, 0.79-0.97), vegetable products (HR/two products, 0.87; 95% CI, 0.79-0.96), and fruit products (HR/two products, 0.84; 95% CI, 0.72-0.97). Conclusion: Variety in vegetable consumption was inversely associated with lung cancer risk among current smokers. Risk of squamous cell carcinomas was reduced with increasing variety in fruit and/or vegetable consumption, which was mainly driven by the effect in current smokers. Impact: Independent from quantity of consumption, variety in fruit and vegetable consumption may decrease lung cancer risk.

Original languageEnglish
Pages (from-to)2278-2286
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Volume19
Issue number9
DOIs
Publication statusPublished - Sep 2010

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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    Büchner, F. L., Bueno-de-Mesquita, H. B., Ros, M. M., Overvad, K., Dahm, C. C., Hansen, L., Tjønneland, A., Clavel-Chapelon, F., Boutron-Ruault, M. C., Touillaud, M., Kaaks, R., Rohrmann, S., Boeing, H., Nöthlings, U., Trichopoulou, A., Zylis, D., Dilis, V., Palli, D., Sieri, S., ... Riboli, E. (2010). Variety in fruit and vegetable consumption and the risk of lung cancer in the European Prospective Investigation into Cancer and Nutrition. Cancer Epidemiology Biomarkers and Prevention, 19(9), 2278-2286. https://doi.org/10.1158/1055-9965.EPI-10-0489