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Intake of fruit and vegetables and risk of bladder cancer: a dose–response meta-analysis of observational studies

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Abstract

Background

Observational studies suggest an association between fruit and vegetables intake and risk of bladder cancer, but the results are controversial.

Methods

We therefore summarized the evidence from observational studies in categorical, linear, and nonlinear, dose–response meta-analysis. Pertinent studies were identified by searching EMBASE and PubMed from their inception to August 2013.

Results

Thirty-one observational studies involving 12,610 cases and 1,121,649 participants were included. The combined rate ratio (RR, 95 % CI) of bladder cancer for the highest versus lowest intake was 0.83 (0.69–0.99) for total fruit and vegetables, 0.81 (0.70–0.93) for total vegetables, 0.77 (0.69–0.87) for total fruit, 0.84 (0.77–0.91) for cruciferous vegetables, 0.79 (0.68–0.91) for citrus fruits, and 0.74 (0.66–0.84) for yellow–orange vegetables. Subgroup analysis showed study design and gender as possible sources of heterogeneity. A nonlinear relationship was found of citrus fruits intake with risk of bladder cancer (P for nonlinearity = 0.018), and the RRs (95 % CI) of bladder cancer were 0.87 (0.78–0.96), 0.80 (0.67–0.94), 0.79 (0.66–0.94), 0.79 (0.65–0.96), and 0.79 (0.64–0.99) for 30, 60, 90, 120, and 150 g/day. A nonlinear relationship was also found of yellow–orange vegetable intake with risk of bladder cancer risk (P for nonlinearity = 0.033). Some evidence of publication bias was observed for fruit, citrus fruits, and yellow–orange vegetables.

Conclusion

This meta-analysis supports the hypothesis that intakes of fruit and vegetables may reduce the risk of bladder cancer. Future well-designed studies are required to confirm this finding.

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Authors and Affiliations

  1. Shanghai Minhang Center for Disease Control and Prevention, 965 Zhongyi Road, Shanghai, 201101, China

    Baodong Yao, Yujie Yan, Hong Fang, Huilin Xu, Yinan Liu & Yanping Zhao

  2. The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai, China

    Xianwu Ye & Sheran Li

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  1. Baodong Yao
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  2. Yujie Yan
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  3. Xianwu Ye
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  4. Hong Fang
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Correspondence to Yanping Zhao.

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Yao, B., Yan, Y., Ye, X. et al. Intake of fruit and vegetables and risk of bladder cancer: a dose–response meta-analysis of observational studies. Cancer Causes Control 25, 1645–1658 (2014). https://doi.org/10.1007/s10552-014-0469-0

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