Citrus fruit and cancer risk in a network of case–control studies
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Citrus fruit has shown a favorable effect against various cancers. To better understand their role in cancer risk, we analyzed data from a series of case–control studies conducted in Italy and Switzerland.
Patients and methods
The studies included 955 patients with oral and pharyngeal cancer, 395 with esophageal, 999 with stomach, 3,634 with large bowel, 527 with laryngeal, 2,900 with breast, 454 with endometrial, 1,031 with ovarian, 1,294 with prostate, and 767 with renal cell cancer. All cancers were incident and histologically confirmed. Controls were admitted to the same network of hospitals for acute, nonneoplastic conditions. Odds ratios (OR) were estimated by multiple logistic regression models, including terms for major identified confounding factors for each cancer site, and energy intake.
The ORs for the highest versus lowest category of citrus fruit consumption were 0.47 (95% confidence interval, CI, 0.36–0.61) for oral and pharyngeal, 0.42 (95% CI, 0.25–0.70) for esophageal, 0.69 (95% CI, 0.52–0.92) for stomach, 0.82 (95% CI, 0.72–0.93) for colorectal, and 0.55 (95% CI, 0.37–0.83) for laryngeal cancer. No consistent association was found with breast, endometrial, ovarian, prostate, and renal cell cancer.
Our findings indicate that citrus fruit has a protective role against cancers of the digestive and upper respiratory tract.
KeywordsCitrus Epidemiology Neoplasms Risk factors
The authors thank Mrs. M. P. Bonifacino for editorial assistance, and Mrs. O. Volpato for study coordination (Unit of Epidemiology and Biostatistic). We are also deeply grateful to Drs. G. Chiara (I General Surgery Department), G. Tosolini (II General Surgery Department) for helping in case enrollment at the General Hospital, Pordenone, as well as to Drs. L. Forner (Eye Diseases Department), A. Mele (Hand Surgery and Microsurgery Department, and E. Trevisanutto (Dermatology Department) for providing control patients at the General Hospital, Pordenone. This study was conducted with the contribution of the Italian Association for Cancer Research and the Italian League against Cancer.
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