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Greater intake of fruit and vegetables is associated with lower risk of nasopharyngeal carcinoma in Chinese adults: a case–control study

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Abstract

Purpose

The effect of fruit and vegetable intake on the risk of nasopharyngeal carcinoma (NPC) remains uncertain due to limited published evidence. We performed a matched case–control study to investigate the relationship between the intake of fruit and vegetables and the risk of NPC.

Methods

Between July 2009 and March 2011, 600 (448 male, 152 female), NPC incident cases from a single hospital in Guangzhou, Guangdong Province, China, a high-incidence area, were enrolled in the study. 600 controls, matched by gender, age (±3 years) and household type (urban/rural) were also enrolled. Face-to-face interviews were used to collect habitual dietary intakes and information on various covariates.

Results

Multivariate conditional logistic regression analyses showed significant, dose-dependent inverse associations between the intake of vegetables, fruit or a combination of the two and the risk of NPC, even after adjustments for social-economic status, body mass index, dietary factors and other potential covariates. The adjusted odds ratios (95% confidence intervals) for NPC in the top quartile of vegetable intake, fruit intake or a combination of the two, as compared to the lowest quartile, were 0.33 (0.22–0.50), 0.70 (0.47–1.04) and 0.37 (0.25–0.55), respectively. Dark green leafy vegetables, carrots, peppers and tomatoes, citrus fruit and pome fruit showed much more pronounced benefits with regards to NPC than other types of fruit and vegetables. Interaction analyses demonstrated that the effects of total combined vegetable and fruit intake were much more significant in subjects with a higher education level (p interaction: 0.027), and the benefits of fruit were observed in males, but not in females (p interaction: 0.088).

Conclusion

Our findings suggest that a greater consumption of fruit and vegetables may lower the risk of NPC in Chinese adults.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

EB virus:

Epstein–Barr virus

NPC:

Nasopharyngeal carcinoma

OR:

Odds ratio

FFQ:

Food frequency questionnaire

TNM stages:

Tumor-lymph-node-metastasis stages

UICC/AJCC:

International Union Against Cancer/American Joint Committee on Cancer

VCA-IgA:

Viral capsid antigen antibody A

EA-IgA:

Early antigen antibody A

SD:

Standard deviation

MET:

Metabolic equivalent

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Acknowledgments

We are grateful for the help from the doctors and nurses in two university affiliated hospitals (the Cancer Center and Ophthalmic Center) of Sun Yat-sen University for facilitating the recruitment and interviews. This study was supported by the 5010 Program for Clinical Researches of Sun Yat-sen University, Guangzhou, People’s Republic of China.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China

    Yuan-ting Liu, Chun-hua Xu, Cai-xia Zhang & Yu-ming Chen

  2. Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China

    Jun-jin Dai, Yu-ying Fan & Xing-lan Zhang

  3. Sun Yat-sen University Ophthalmic Center, Guangzhou, People’s Republic of China

    Yun-kai Lu

  4. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China

    Yu-ming Chen

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  1. Yuan-ting Liu
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Correspondence to Yu-ming Chen.

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Liu, Yt., Dai, Jj., Xu, Ch. et al. Greater intake of fruit and vegetables is associated with lower risk of nasopharyngeal carcinoma in Chinese adults: a case–control study. Cancer Causes Control 23, 589–599 (2012). https://doi.org/10.1007/s10552-012-9923-z

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