期刊
INTERNATIONAL JOURNAL OF CANCER
卷 131, 期 6, 页码 E963-E973出版社
WILEY
DOI: 10.1002/ijc.27517
关键词
gastric cancer; esophageal cancer; vegetable and fruit; variety; EPIC
类别
资金
- European Commission: Public Health and Consumer Protection Directorate
- Research Directorate-General
- Ligue contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France)
- German Cancer Aid, Federal Ministry of Education and Research (Germany)
- Danish Cancer Society (Denmark)
- Health Research Fund (FIS) of the Spanish Ministry of Health
- CIBER en Epidmeiologica y Salud Publica (CIBERESP)
- ISCIII RETIC [RD06/0020]
- Spanish Regional Governments of Andalusia, Asturias, Basque Country, Murcia [6236]
- Catalan Institute of Oncology (Spain)
- Cancer Research UK
- Medical Research Council
- Stroke Association
- British Heart Foundation
- Department of Health
- Food Standards Agency
- Wellcome Trust (United Kingdom)
- Greek Ministry of Health and Social Solidarity
- Hellenic Health Foundation
- Stavros Niarchos Foundation (Greece)
- Italian Association for Research on Cancer, National Research Council (Italy)
- Dutch Ministry of Health, Welfare and Sports
- Dutch Prevention Funds
- LK Research Funds
- Dutch ZON (Zorg Onderzoek Nederland)
- World Cancer Research Fund (WCRF)
- Statistics Netherlands (The Netherlands)
- Swedish Cancer Society
- Swedish Scientific Council
- Regional Government of Skane (Sweden)
- Nordforsk (Centre of excellence programme Helga) (Norway)
- Cancer Research UK [14136] Funding Source: researchfish
- Medical Research Council [G0801056B, MC_U106179471, G1000143, G0401527] Funding Source: researchfish
Diets high in vegetables and fruits have been suggested to be inversely associated with risk of gastric cancer. However, the evidence of the effect of variety of consumption is limited. We therefore investigated whether consumption of a variety of vegetables and fruit is associated with gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition study. Data on food consumption and follow-up on cancer incidence were available for 452,269 participants from 10 European countries. After a mean follow-up of 8.4 years, 475 cases of gastric and esophageal adenocarcinomas (180 noncardia, 185 cardia, gastric esophageal junction and esophagus, 110 not specified) and 98 esophageal squamous cell carcinomas were observed. Diet Diversity Scores were used to quantify the variety in vegetable and fruit consumption. We used multivariable Cox proportional hazard models to calculate risk ratios. Independent from quantity of consumption, variety in the consumption of vegetables and fruit combined and of fruit consumption alone were statistically significantly inversely associated with the risk of esophageal squamous cell carcinoma (continuous hazard ratio per 2 products increment 0.88; 95% CI 0.790.97 and 0.76; 95% CI 0.620.94, respectively) with the latter particularly seen in ever smokers. Variety in vegetable and/or fruit consumption was not associated with risk of gastric and esophageal adenocarcinomas. Independent from quantity of consumption, more variety in vegetable and fruit consumption combined and in fruit consumption alone may decrease the risk of esophageal squamous cell carcinoma. However, residual confounding by lifestyle factors cannot be excluded.
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