Objective: The purpose was to study the association between vegetable and fruit consumption and lung cancer incidence using 1074 cases after 6.3 years of follow-up in the Netherlands Cohort Study.
Methods: Dietary intake was assessed using a 150-item food-frequency questionnaire. Multivariate models were used including age, sex, family history of lung cancer, highest educational level attained, and smoking history.
Results: Statistically significant inverse associations were found with total vegetables and most vegetable groups. Rate ratios (RRs) based on consumption frequency showed the strongest effect of vegetables from the Brassica group (RR 0.5, 95% confidence interval (95% CI) 0.3–0.9, for consumption ≥3 times per week versus ≤ once a month). RR of highest versus lowest quintile of total vegetable consumption was 0.7 (95% CI 0.5–1.0, p-trend 0.001). Statistically significant inverse associations were found for all fruits listed in the questionnaire. RRs for quintiles of total fruit intake were 1.0, 0.7, 0.6, 0.6 and 0.8 respectively (p-trend < 0.0001). Protective effects of fruits and vegetables were stronger in current than in former smokers, and weaker for adenocarcinomas than for other types of tumors.
Conclusions: Inverse associations with lung cancer are found for both vegetable and fruit intake, but no specific type of vegetable or fruit seems to be particularly responsible.
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Steinmetz KA, Potter JD (1991) Vegetables, fruit, and cancer. I. Epidemiology. Cancer Causes Control 2: 325–357.
Steinmetz KA, Potter JD (1996) Vegetables, fruit, and cancer prevention: a review. J Am Diet Assoc 96: 1027–1039.
Block G, Patterson B, Subar A (1992) Fruit, vegetables, and cancer prevention: a review of the epidemiological evidence. Nutr Cancer 18: 1–29.
Ziegler RG, Mayne ST, Swanson CA (1996) Nutrition and lung cancer. Cancer Causes Control 7: 157–177.
Knekt P, Jarvinen R, Seppänen R, et al. (1991) Dietary antioxidants and the risk of lung cancer. Am J Epidemiol 134: 471–479.
Kvåle G, Bjelke E, Gart JJ (1983) Dietary habits and lung cancer risk. Int J Cancer Inst 31: 397–405.
Ocké MC, Bueno de Mesquita HB, Feskens EJM, van Staveren WA, Kromhout D (1997) Repeated measurements of vegetables, fruits, b-carotene, and vitamins C and E in relation to lung cancer. Am J Epidemiol 145: 358–365.
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.
Steinmetz KA, Potter JD, Folsom AR (1993) Vegetables, fruit, and lung cancer in the Iowa Women's Health Study. Cancer Res 53: 536–543.
Long-de W, Hammond C (1985) Lung cancer, fruit, green salad and vitamin pills. Chin Med J 98: 206–210.
Fraser GE, Beeson WL, Phillips RL (1991) Diet and lung cancer in California Seventh-day Adventists. Am J Epidemiol 133: 683–693.
Hirayama T (1990) Contribution of a long-term prospective cohort study to the issue of nutrition and cancer with special reference to the role of alcohol drinking. Prog Clin Biol Res 346: 179–187.
Shibata A, Paganini-Hill A, Ross RK, Yu MC, Henderson BE (1992) Dietary beta-carotene, cigarette smoking, and lung cancer in men. Cancer Causes Control 3: 207–214.
Chow WH, Schuman LM, McLaughin JK, et al. (1992) A cohort study of tobacco use, diet, occupation, and lung cancer mortality. Cancer Causes Control 3: 247–254.
Yong LC, Brown CC, Schatzkin A, et al. (1997) Intake of vitamins E, C, and A and risk of lung cancer-The NHANES I Epidemiologic Followup Study. Am J Epidemiol 146: 231–243.
Kromhout D (1987) Essential micronutrients in relation to carcinogenesis. Am J Clin Nutr 45: 1361–1367.
Dorant E, van den Brandt PA, Goldbohm RA (1994) A prospective cohort study on Allium vegetable consumption, garlic supplement use, and the risk of lung carcinoma in the Netherlands. Cancer Res 54: 6148–6153.
van den Brandt PA, Goldbohm RA, van't Veer P, Volovics A, Hermus RJJ, Sturmans F (1990) A large-scale prospective cohort study on diet and cancer in The Netherlands. J Clin Epidemiol 43: 285–295.
Goldbohm RA, van den Brandt PA, Brants HAM, et al. (1994) Validation of a dietary questionnaire used in a large-scale prospective cohort study on diet and cancer. Eur J Clin Nutr 48: 253–265.
van den Brandt PA, Schouten LJ, Goldbohm RA, Dorant E, Hunen PMH (1990) Development of a record linkage protocol for use in the Dutch cancer registry for epidemiological research. Int J Epidemiol 19: 553–558.
Self SG, Prentice RL (1988) Asymptotic distribution theory and efficiency results for case-cohort studies. Ann Stat 16: 64–81.
Baker RJ (1985) GLIM 3.77 Reference Manual. Oxford: Numerical Algorithms Group.
Volovics A, van den Brandt PA (1997) Methods for the analyses of case-cohort studies. Biomed J 2: 195–214.
Doll R, Hill AB, Kreyberg L (1957) The significance of cell type in relation to the aetiology of lung cancer. Br J Cancer 11: 43–48.
Morabia A, Wynder EL (1990) Dietary habits of smokers, people who never smoked, and exsmokers. Am J Clin Nutr 52: 933–937.
Potter JD, Sellers TA, Folsom AR, McGovern PG (1992) Alcohol, beer, and lung cancer in postmenopausal women. The Iowa Women's Health Study. Ann Epidemiol 2: 587–595.
Bandera EV, Freudenheim JL, Graham S, et al. (1992) Alcohol consumption and lung cancer in white males. Cancer Causes Control 3: 361–369.
Ocké MC, Bueno de Mesquita HB, Goddijn HE, et al. (1997) The Dutch EPIC food frequency questionnaire. I. Description of the questionnaire, and relative validity and reproducibility for food groups. Int J Epidemiol 26 (Suppl. 1): S37–S48.
Smith-Warner SA, Elmer PJ, Fosdick L, Tharp TM, Randall B (1997) Reliability and comparability of three dietary assessment methods for estimating fruit and vegetable intakes. Epidemiology 8: 196–201.
Verhoeven DTH, Goldbohm RA (1997) Validering van groentengegevens in de Nederlandse Cohortstudie naar voeding en kanker. TNO rapport V97.151/NLCS 97-02. TNO Voeding Zeist.
Verhoeven DTH, Verhagen H, Goldbohm RA, van den Brandt PA, van Poppel G (1997) A review of mechanisms underlying anticarcinogenicity by brassica vegetables. Chem Biol Interact 103: 79–129.
Mooney LA, Bell DA, Santella RM, et al. (1997) Contribution of genetic nutritional factors to DNA damage in heavy smokers. Carcinogenesis 18: 503–509.
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Voorrips, L.E., Goldbohm, R.A., Verhoeven, D.T. et al. Vegetable and fruit consumption and lung cancer risk in the Netherlands Cohort Study on Diet and Cancer. Cancer Causes Control 11, 101–115 (2000). https://doi.org/10.1023/A:1008906706084
- cohort study
- lung cancer