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Fruit and vegetable intake and gastric cancer risk in a large United States prospective cohort study



Fruit and vegetable intake may protect against gastric cancer incidence. Results from case–control studies have indicated an inverse association, but results from cohort studies are inconsistent.


We prospectively investigated the association in 490,802 participants of the NIH-AARP Diet and Health Study using Cox proportional hazards models adjusted for gastric cancer risk factors. We present hazard ratios (HR) and 95% confidence intervals (CI) per increase of one daily serving per 1,000 calories.


During 2,193,751 person years, 394 participants were diagnosed with incident gastric cancer. We observed no significant associations between total fruit and vegetable intake (1.01, 0.95–1.08), fruit intake (1.04, 0.95–1.14), or vegetable intake (0.98, 0.88–1.08) and gastric cancer risk. Results did not vary by sex or anatomic subsite (cardia versus non-cardia). All 13 botanical subgroups examined had no significant associations with either anatomic sub-site.


We did not observe significant associations between overall fruit and vegetable intake and gastric cancer risk in this large prospective cohort study.

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Cancer incidence data from the Atlanta metropolitan area were collected by the Georgia Center for Cancer Statistics, Department of Epidemiology, Rollins School of Public Health, Emory University. Cancer incidence data from California were collected by the California Department of Health Services, Cancer Surveillance Section. Cancer incidence data from the Detroit metropolitan area were collected by the Michigan Cancer Surveillance Program, Community Health Administration, State of Michigan. The Florida cancer incidence data used in this report were collected by the Florida Cancer Data System under contract to the Department of Health (DOH). The views expressed herein are solely those of the authors and do not necessarily reflect those of the contractor or DOH. Cancer incidence data from Louisiana were collected by the Louisiana Tumor Registry, Louisiana State University Medical Center in New Orleans. Cancer incidence data from New Jersey were collected by the New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey State Department of Health and Senior Services. Cancer incidence data from North Carolina were collected by the North Carolina Central Cancer Registry. Cancer incidence data from Pennsylvania were supplied by the Division of Health Statistics and Research, Pennsylvania Department of Health, Harrisburg, Pennsylvania. The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations or conclusions. We are indebted to the participants in the NIH-AARP Diet and Health Study for their outstanding cooperation. This research was supported by the Intramural Research Program of the National Cancer Institute, National Institutes of Health.

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Correspondence to Neal D. Freedman.

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Freedman, N.D., Subar, A.F., Hollenbeck, A.R. et al. Fruit and vegetable intake and gastric cancer risk in a large United States prospective cohort study. Cancer Causes Control 19, 459–467 (2008).

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