Cancer Causes & Control

, Volume 15, Issue 4, pp 349–357 | Cite as

Vegetables, Fruit Consumption and Risk of Lung Cancer among Middle-Aged Japanese Men and Women: JPHC Study

  • Ying Liu
  • Tomotaka Sobue
  • Tetsuya Otani
  • Shoichiro Tsugane

Abstract

Objective: To investigate the association between vegetable and fruit consumption and incidence of lung cancer.

Methods: Self-administered questionnaires were used to assess diet in two large population-based cohorts with 42,224 and 51,114 subjects in 1990 and 1993, respectively. After ten and seven years of follow-up, we ascertained 428 newly diagnosed case of lung cancer. Relative risk (RR) estimates were calculated using the Cox proportional hazards model with pooling of estimates from the two cohorts.

Results: Total vegetable and fruit intake was not associated with lowered risk of lung cancer, with RR approximating unity. The null relation between vegetable and fruit consumption and lung cancer incidence was consistent across strata of smoking status (never or ever smokers). When dividing lung cancers into adenocarcinoma and non-adenocarcinoma, risk for middle and high intakes of vegetables only, fruit only, and vegetables and fruit combined were all below one for non-adenocarcinoma and above one for adenocarcinoma, although no statistically significant differences were noted. Similar patterns of results were found when the two cohorts were analyzed separately.

Conclusions: Contrary to popular belief, our results suggest that vegetables and fruit do not appear to confer protection from lung cancer.

lung cancer non-adenocarcinoma prospective study smoking vegetable and fruit consumption 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Smith-Warner SA, Spiegelman D, Yaun SS, et al. (2003) Fruits, vegetables and lung cancer: a pooled analysis of cohort studies. Int J Cancer 107: 1001–1011.PubMedGoogle Scholar
  2. 2.
    Riboli E, Norat T (2003) Epidemiologic evidence of the protective effect of fruit and vegetables on cancer risk. Am J Clin Nutr 78: 559S–569S.PubMedGoogle Scholar
  3. 3.
    Axelsson G, Liljeqvist T, Andersson L, Bergman B, Rylander R (1996) Dietary factors and lung cancer among men in west Sweden. Int J Epidemiol 25: 32–39.PubMedGoogle Scholar
  4. 4.
    Pillow PC, Hursting SD, Duphorne CM., et al. (1997) Case-control assessment of diet and lung cancer risk in African Americans and Mexican Americans. Nutr Cancer 29: 169–173.PubMedGoogle Scholar
  5. 5.
    Wright ME, Mayne ST, Swanson CA, Sinha R, Alavanja MC (2003) Dietary carotenoids, vegetables, and lung cancer risk in women: the Missouri women's health study (United States). Cancer Causes Control 14: 85–96.PubMedGoogle Scholar
  6. 6.
    Alavanja MC, Brown CC, Swanson C, Brownson RC (1993) Saturated fat intake and lung cancer risk among nonsmoking women in Missouri. J Natl Cancer Inst 85: 1906–1916.PubMedGoogle Scholar
  7. 7.
    Suzuki I, Hamada GS, Zamboni MM, Cordeiro Pde B, Watanabe S, Tsugane S (1994) Risk factors for lung cancer in Rio de Janeiro, Brazil: a case-control study. Lung Cancer 11: 179–190.PubMedGoogle Scholar
  8. 8.
    Chow WH, Schuman LM, McLaughlin JK, et al. (1992) A cohort study of tobacco use, diet, occupation, and lung cancer mortality. Cancer Causes Control 3: 247–254.PubMedGoogle Scholar
  9. 9.
    Ziegler RG, Mason TJ, Stemhagen A, et al. (1986) Carotenoid intake, vegetables, and the risk of lung cancer among white men in New Jersey. Am J Epidemiol 123: 1080–1093.PubMedGoogle Scholar
  10. 10.
    Jansen MC, Bueno-de-Mesquita HB, Rasanen L, et al. (2001) Cohort analysis of fruit and vegetable consumption and lung cancer mortality in European men. Int J Cancer 92: 913–918.PubMedGoogle Scholar
  11. 11.
    Ozasa K, Watanabe Y, Ito Y, et al. (2001) Dietary habits and risk of lung cancer death in a large-scale cohort study (JACC Study) in Japan by sex and smoking habit. Jpn J Cancer Res 92: 1259–1269.PubMedGoogle Scholar
  12. 12.
    Voorrips LE, Goldbohm RA, Verhoeven DT, et al. (2000) Vegetable and fruit consumption and lung cancer risk in the Netherlands Cohort Study on diet and cancer. Cancer Causes Control 11: 101–115.PubMedGoogle Scholar
  13. 13.
    Mayne ST, Janerich DT, Greenwald P, et al. (1994) Dietary beta carotene and lung cancer risk in U.S. nonsmokers. J Natl Cancer Inst 86: 33–38.PubMedGoogle Scholar
  14. 14.
    Brennan P, Fortes C, Butler J, et al. (2000) A multicenter case-control study of diet and lung cancer among non-smokers. Cancer Causes Control 11: 49–58.PubMedGoogle Scholar
  15. 15.
    Nyberg F, Agrenius V, Svartengren K, Svensson C, Pershagen G (1998) Dietary factors and risk of lung cancer in never-smokers. Int J Cancer 78: 430–436.PubMedGoogle Scholar
  16. 16.
    Feskanich D, Ziegler RG, Michaud DS, et al. (2000) Prospective study of fruit and vegetable consumption and risk of lung cancer among men and women. J Natl Cancer Inst 92: 1812–1823.PubMedGoogle Scholar
  17. 17.
    Caicoya M (2002) [Lung cancer and vegetable consumption in Asturias, Spain. A case-control study]. Med Clin (Barc) 119: 206–210.Google Scholar
  18. 18.
    Kubik A, Zatloukal P, Tomasek L, Kriz J, Petruzelka L, Plesko I (2001) Diet and the risk of lung cancer among women. A hospital-based case-control study. Neoplasma 48: 262–266.PubMedGoogle Scholar
  19. 19.
    Takezaki T, Hirose K, Inoue M et al. (2001) Dietary factors and lung cancer risk in Japanese: with special reference to fish consumption and adenocarcinomas. Br J Cancer 84: 1199–1206.PubMedGoogle Scholar
  20. 20.
    Tsugane S, Sobue T (2001) Baseline survey of JPHC study-design and participation rate. Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases. J Epidemiol 11: S24–S29.PubMedGoogle Scholar
  21. 21.
    Tsubono Y, Sasaki S, Kobayashi M, Akabane M, Tsugane S (2001) Food composition and empirical weight methods in predicting nutrient intakes from food frequency questionnaire. Ann Epidemiol 11: 213–218.PubMedGoogle Scholar
  22. 22.
    World Health Organization (1990) International classification of diseases for oncology. WHO, Geneva.Google Scholar
  23. 23.
    Michels KB, Edward G, Joshipura KJ, et al. (2000) Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers. J Natl Cancer Inst 92: 1740–1752.PubMedGoogle Scholar
  24. 24.
    Association, H.a.W.S. (2000) J Health Welfare Statist 736: 90.Google Scholar
  25. 25.
    Fund A.I.f.C.R.W.C.R. (1997) Food, nutrition, and the prevention of cancer: a global perspective. American Institute for Cancer Research, Washington, DC.Google Scholar
  26. 26.
    Shibata A, Paganini-Hill A, Ross RK, Henderson BE (1992) Intake of vegetables, fruits, beta-carotene, vitamin C and vitamin supplements and cancer incidence among the elderly: a prospective study. Br J Cancer 66: 673–679.PubMedGoogle Scholar
  27. 27.
    Knekt P, Jarvinen R, Teppo L, Aromaa A, Seppanen R (1999) Role of various carotenoids in lung cancer prevention. J Natl Cancer Inst 91: 182–184.PubMedGoogle Scholar
  28. 28.
    Sobue T, Yamamoto S, Hara M, Sasazuki S, Sasaki S, Tsugane S (2002) Cigarette smoking and subsequent risk of lung cancer by histologic type in middle-aged Japanese men and women: the JPHC study. Int J Cancer 99: 245–251.PubMedGoogle Scholar
  29. 29.
    Koo LC (1997) Diet and lung cancer 20+ years later: more questions than answers? Int J Cancer Suppl 10, 22–29.Google Scholar
  30. 30.
    ¦ (1994) The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. N Engl J Med 330: 1029–1035.PubMedGoogle Scholar
  31. 31.
    Omenn GS, Goodman GE, Thornquist MD, et al. (1996) Risk factors for lung cancer and for intervention effects in CARET, the Beta-Carotene and Retinol Efficacy Trial. J Natl Cancer Inst 88: 1550–1559.PubMedGoogle Scholar
  32. 32.
    Information, R.C.o.H.a.N. (2000) National Nutrition Survey, Japan, 1998. Daiichi-shuppan Co., Tokyo.Google Scholar
  33. 33.
    Ocke MC, Bueno-de-Mesquita HB, Feskens EJ, van Staveren WA, Kromhout D (1997) Repeated measurements of vegetables, fruits, beta-carotene, and vitamins C and E in relation to lung cancer. The Zutphen Study. Am J Epidemiol 145: 358–365.PubMedGoogle Scholar
  34. 34.
    Krebs-Smith SM, Subar AF, Paterson BH, Pivonka E (1995) Using food frequency questionnairs to estimate fruit and vegetable intake: association between the number of questions and total intakes. J Nutr Educ 27: 80–85.Google Scholar
  35. 35.
    Fahey MT, Sasaki S, Kobayashi M, Akabane M, Tsugane, S (2003) Seasonal misclassification error and magnitude of true between-person variation in dietary nutrient intake: a random coefficients analysis and implications for the Japan Public Health Center (JPHC) Cohort Study. Public Health Nutr 6: 385–391.PubMedGoogle Scholar
  36. 36.
    Knekt P, Jarvinen R, Seppanen R, et al. (1997) Dietary flavonoids and the risk of lung cancer and other malignant neoplasms. Am J Epidemiol 146: 223–230.PubMedGoogle Scholar
  37. 37.
    Arts IC, Hollman PC, Bueno De Mesquita HB, Feskens EJ, Kromhout D (2001) Dietary catechins and epithelial cancer incidence: the Zutphen elderly study. Int J Cancer 92: 298–302.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Ying Liu
    • 1
  • Tomotaka Sobue
    • 1
  • Tetsuya Otani
    • 1
  • Shoichiro Tsugane
    • 1
  1. 1.Statistics and Cancer Control DivisionNational Cancer CenterTokyoJapan

Personalised recommendations