Cancer Causes & Control

, 17:957

Intake of fruits and vegetables and risk of cancer of the upper aero-digestive tract: the prospective EPIC-study

  • Heiner Boeing
  • Thomas Dietrich
  • Kurt Hoffmann
  • Tobias Pischon
  • Pietro Ferrari
  • Petra H. Lahmann
  • Marie Christine Boutron-Ruault
  • Francoise Clavel-Chapelon
  • Naomi Allen
  • Tim Key
  • Guri Skeie
  • Eiliv Lund
  • Anja Olsen
  • Anne Tjonneland
  • Kim Overvad
  • Majken K. Jensen
  • Sabine Rohrmann
  • Jakob Linseisen
  • Antonia Trichopoulou
  • Christina Bamia
  • Theodora Psaltopoulou
  • Lars Weinehall
  • Ingegerd Johansson
  • Maria-José Sánchez
  • Paula Jakszyn
  • Eva Ardanaz
  • Pilar Amiano
  • Maria Dolores Chirlaque
  • J. Ramón Quirós
  • Elisabet Wirfalt
  • Göran Berglund
  • Petra H. Peeters
  • Carla H. van Gils
  • H. Bas Bueno-de-Mesquita
  • Frederike L. Büchner
  • Franco Berrino
  • Domenico Palli
  • Carlotta Sacerdote
  • Rosario Tumino
  • Salvatore Panico
  • Sheila Bingham
  • Kay-Tee Khaw
  • Nadia Slimani
  • Teresa Norat
  • Mazda Jenab
  • Elio Riboli
Original Paper

Abstract

Epidemiologic studies suggest that a high intake of fruits and vegetables is associated with decreased risk of cancers of the upper aero-digestive tract. We studied data from 345,904 subjects of the prospective European Investigation into Cancer and Nutrition (EPIC) recruited in seven European countries, who had completed a dietary questionnaire in 1992–1998. During 2,182,560 person years of observation 352 histologically verified incident squamous cell cancer (SCC) cases (255 males; 97 females) of the oral cavity, pharynx, larynx, and esophagus were identified. Linear and restricted cubic spline Cox regressions were fitted on variables of intake of fruits and vegetables and adjusted for potential confounders. We observed a significant inverse association with combined total fruits and vegetables intake (estimated relative risk (RR) = 0.91; 95% confidence interval (95% CI) 0.83–1.00 per 80 g/d of consumption), and nearly significant inverse associations in separate analyses with total fruits and total vegetables intake (RR: 0.97 (95% CI: 0.92–1.02) and RR = 0.89 (95% CI: 0.78–1.02) per 40 g/d of consumption). Overall, vegetable subgroups were not related to risk with the exception of intake of root vegetables in men. Restricted cubic spline regression did not improve the linear model fits except for total fruits and vegetables and total fruits with a significant decrease in risk at low intake levels (<120 g/d) for fruits. Dietary recommendations should consider the potential benefit of increasing fruits and vegetables consumption for reducing the risk of cancers of the upper aero-digestive tract, particularly at low intake.

Keywords

Upper aero-digestive cancer Fruits and vegetables Root vegetables Prospective study EPIC Relative risk 

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Heiner Boeing
    • 1
  • Thomas Dietrich
    • 1
  • Kurt Hoffmann
    • 1
  • Tobias Pischon
    • 1
  • Pietro Ferrari
    • 2
  • Petra H. Lahmann
    • 1
  • Marie Christine Boutron-Ruault
    • 3
  • Francoise Clavel-Chapelon
    • 3
  • Naomi Allen
    • 4
  • Tim Key
    • 4
  • Guri Skeie
    • 5
  • Eiliv Lund
    • 5
  • Anja Olsen
    • 6
  • Anne Tjonneland
    • 6
  • Kim Overvad
    • 7
  • Majken K. Jensen
    • 7
  • Sabine Rohrmann
    • 8
  • Jakob Linseisen
    • 8
  • Antonia Trichopoulou
    • 9
  • Christina Bamia
    • 9
  • Theodora Psaltopoulou
    • 9
  • Lars Weinehall
    • 10
  • Ingegerd Johansson
    • 10
  • Maria-José Sánchez
    • 11
  • Paula Jakszyn
    • 12
  • Eva Ardanaz
    • 13
  • Pilar Amiano
    • 14
  • Maria Dolores Chirlaque
    • 15
  • J. Ramón Quirós
    • 16
  • Elisabet Wirfalt
    • 17
  • Göran Berglund
    • 17
  • Petra H. Peeters
    • 18
  • Carla H. van Gils
    • 18
  • H. Bas Bueno-de-Mesquita
    • 19
  • Frederike L. Büchner
    • 19
  • Franco Berrino
    • 20
  • Domenico Palli
    • 21
  • Carlotta Sacerdote
    • 22
  • Rosario Tumino
    • 23
  • Salvatore Panico
    • 24
  • Sheila Bingham
    • 25
  • Kay-Tee Khaw
    • 26
  • Nadia Slimani
    • 2
  • Teresa Norat
    • 2
  • Mazda Jenab
    • 2
  • Elio Riboli
    • 2
  1. 1.German Institute of Human Nutrition Potsdam-Rehbrücke NuthetalGermany
  2. 2.Nutrition and Hormones GroupInternational Agency for Research on CancerLyonFrance
  3. 3.Institute Gustave RoussyINSERM U521VillejuifFrance
  4. 4.Cancer Research UK Epidemiology UnitUniversity of OxfordOxfordUK
  5. 5.Institute of Community MedicineUniversity of TromsoTromsoNorway
  6. 6.Institute of Cancer EpidemiologyDanish Cancer SocietyCopenhagenDenmark
  7. 7.Department of Clinical Epidemiology, Aalborg Hospital and the Aarhus University Hospital, Department of Epidemiology and Social MedicineUniversity of AarhusAarhusDenmark
  8. 8.Division of Clinical EpidemiologyGerman Cancer Research CenterHeidelbergGermany
  9. 9.Department of Hygiene and Epidemiology, Medical SchoolUniversity of AthensAthensGreece
  10. 10.Department of Nutritional Research and The Department of Medical Biosciences, PathologyUniversity of UmeåUmeåSweden
  11. 11.Andalusian School of Public HealthGranadaSpain
  12. 12.Department of EpidemiologyCatalan Institute of OncologyBarcelonaSpain
  13. 13.Public Health Institute of NavarraPamplonaSpain
  14. 14.Health Department of Basque CountrySan SebastianSpain
  15. 15.Epidemiology DepartmentMurcia Health CouncilMurciaSpain
  16. 16.Council for Health and Social Affairs of AsturiasOviedoSpain
  17. 17.Malmö Diet and Cancer Study, Department of Clinical SciencesLund UniversityMalmöSweden
  18. 18.Julius Center for Health Sciences and Primary CareUniversity Medical CenterUtrechtThe Netherlands
  19. 19.Center for Nutrition and HealthNational Institute for Public Health and The EnvironmentBilthovenThe Netherlands
  20. 20.Epidemiology UnitIstituto TumoriMilanItaly
  21. 21.The Molecular and Nutritional Epidemiology Unit, CSPOScientific Institute of TuscanyFlorenceItaly
  22. 22.University of TorinoTorinoItaly
  23. 23.Cancer RegistryAzienda Ospedaliera “Civile M. P. Arezzo”RagusaItaly
  24. 24.Department of Clinical and Experimental MedicineFederico II UniversityNaplesItaly
  25. 25.Dunn Human Nutrition UnitCambridgeUK
  26. 26.The Clinical Gerontology UnitUniversity of CambridgeCambridgeUK

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