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Fruits, vegetables and lung cancer: a pooled analysis of cohort studies.

Abstract

Inverse associations between fruit and vegetable consumption and lung cancer risk have been consistently reported. However, identifying the specific fruits and vegetables associated with lung cancer is difficult because the food groups and foods evaluated have varied across studies. We analyzed fruit and vegetable groups using standardized exposure and covariate definitions in 8 prospective studies. We combined study-specific relative risks (RRs) using a random effects model. In the pooled database, 3,206 incident lung cancer cases occurred among 430,281 women and men followed for up to 6-16 years across studies. Controlling for smoking habits and other lung cancer risk factors, a 16-23% reduction in lung cancer risk was observed for quintiles 2 through 5 vs. the lowest quintile of consumption for total fruits (RR = 0.77; 95% CI = 0.67-0.87 for quintile 5; p-value, test for trend < 0.001) and for total fruits and vegetables (RR = 0.79; 95% CI = 0.69-0.90; p-value, test for trend = 0.001). For the same comparison, the association was weaker for total vegetable consumption (RR = 0.88; 95% CI = 0.78-1.00; p-value, test for trend = 0.12). Associations were similar between never, past, and current smokers. These results suggest that elevated fruit and vegetable consumption is associated with a modest reduction in lung cancer risk, which is mostly attributable to fruit, not vegetable, intake. However, we cannot rule out the possibility that our results are due to residual confounding by smoking. The primary focus for reducing lung cancer incidence should continue to be smoking prevention and cessation.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.

    , , , , , , , , , , , , , , , , , ,

    Source

    International journal of cancer 107:6 2003 Dec 20 pg 1001-11

    MeSH

    Analysis of Variance
    Cohort Studies
    Female
    Fruit
    Humans
    Lung Neoplasms
    Male
    Reproducibility of Results
    Risk
    Risk Factors
    Sample Size
    Smoking
    Vegetables

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    14601062

    Citation

    Smith-Warner, Stephanie A., et al. "Fruits, Vegetables and Lung Cancer: a Pooled Analysis of Cohort Studies." International Journal of Cancer, vol. 107, no. 6, 2003, pp. 1001-11.
    Smith-Warner SA, Spiegelman D, Yaun SS, et al. Fruits, vegetables and lung cancer: a pooled analysis of cohort studies. Int J Cancer. 2003;107(6):1001-11.
    Smith-Warner, S. A., Spiegelman, D., Yaun, S. S., Albanes, D., Beeson, W. L., van den Brandt, P. A., ... Hunter, D. J. (2003). Fruits, vegetables and lung cancer: a pooled analysis of cohort studies. International Journal of Cancer, 107(6), pp. 1001-11.
    Smith-Warner SA, et al. Fruits, Vegetables and Lung Cancer: a Pooled Analysis of Cohort Studies. Int J Cancer. 2003 Dec 20;107(6):1001-11. PubMed PMID: 14601062.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Fruits, vegetables and lung cancer: a pooled analysis of cohort studies. AU - Smith-Warner,Stephanie A, AU - Spiegelman,Donna, AU - Yaun,Shiaw-Shyuan, AU - Albanes,Demetrius, AU - Beeson,W Lawrence, AU - van den Brandt,Piet A, AU - Feskanich,Diane, AU - Folsom,Aaron R, AU - Fraser,Gary E, AU - Freudenheim,Jo L, AU - Giovannucci,Edward, AU - Goldbohm,R Alexandra, AU - Graham,Saxon, AU - Kushi,Lawrence H, AU - Miller,Anthony B, AU - Pietinen,Pirjo, AU - Rohan,Thomas E, AU - Speizer,Frank E, AU - Willett,Walter C, AU - Hunter,David J, PY - 2003/11/6/pubmed PY - 2004/1/15/medline PY - 2003/11/6/entrez SP - 1001 EP - 11 JF - International journal of cancer JO - Int. J. Cancer VL - 107 IS - 6 N2 - Inverse associations between fruit and vegetable consumption and lung cancer risk have been consistently reported. However, identifying the specific fruits and vegetables associated with lung cancer is difficult because the food groups and foods evaluated have varied across studies. We analyzed fruit and vegetable groups using standardized exposure and covariate definitions in 8 prospective studies. We combined study-specific relative risks (RRs) using a random effects model. In the pooled database, 3,206 incident lung cancer cases occurred among 430,281 women and men followed for up to 6-16 years across studies. Controlling for smoking habits and other lung cancer risk factors, a 16-23% reduction in lung cancer risk was observed for quintiles 2 through 5 vs. the lowest quintile of consumption for total fruits (RR = 0.77; 95% CI = 0.67-0.87 for quintile 5; p-value, test for trend < 0.001) and for total fruits and vegetables (RR = 0.79; 95% CI = 0.69-0.90; p-value, test for trend = 0.001). For the same comparison, the association was weaker for total vegetable consumption (RR = 0.88; 95% CI = 0.78-1.00; p-value, test for trend = 0.12). Associations were similar between never, past, and current smokers. These results suggest that elevated fruit and vegetable consumption is associated with a modest reduction in lung cancer risk, which is mostly attributable to fruit, not vegetable, intake. However, we cannot rule out the possibility that our results are due to residual confounding by smoking. The primary focus for reducing lung cancer incidence should continue to be smoking prevention and cessation. SN - 0020-7136 UR - https://www.unboundmedicine.com/medline/citation/14601062/Fruits_vegetables_and_lung_cancer:_a_pooled_analysis_of_cohort_studies_ L2 - https://doi.org/10.1002/ijc.11490 DB - PRIME DP - Unbound Medicine ER -