Journal
INTERNATIONAL JOURNAL OF CANCER
Volume 141, Issue 2, Pages 287-297Publisher
WILEY
DOI: 10.1002/ijc.30741
Keywords
prostate cancer; fruit; vegetable; tumor subtypes; prospective
Categories
Funding
- Cancer Research UK [C8221/A19170, 14136, C570/A16491]
- European Commission (DG-SANCO)
- International Agency for Research on Cancer
- Danish Cancer Society (Denmark
- National Cohorts)
- German Cancer Aid
- German Cancer Research Center (DKFZ)
- Federal Ministry of Education and Research (BMBF)
- Deutsche Krebshilfe
- Deutsches Krebsforschungszentrum
- Federal Ministry of Education and Research (Germany)
- Hellenic Health Foundation (Greece)
- Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy
- National Research Council (Italy)
- Ministry of Public Health, Welfare and Sports (VWS)
- Netherlands Cancer Registry (NKR)
- LK Research Funds
- Dutch Prevention Funds
- Dutch ZON (Zorg Onderzoek Nederland)
- World Cancer Research Fund (WCRF)
- Statistics Netherlands (The Netherlands)
- Health Research Fund (FIS) [PI13/00061, PI13/01162]
- Regional Government of Andalucia
- Regional Government of Asturias
- Regional Government of Basque Country
- Regional Government of Murcia
- Regional Government of Navarra [RD12/0036/0018]
- Swedish Cancer Society
- Swedish Research Council
- County Council of Skane
- County Council of Vasterbotten (Sweden)
- Medical Research Council [1000143, MR/M012190/1]
- Cancer Research UK [16491, 14136, 19170] Funding Source: researchfish
- Medical Research Council [MR/M012190/1, G0401527, G1000143, MR/N003284/1] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10114] Funding Source: researchfish
- MRC [MR/N003284/1] Funding Source: UKRI
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Several dietary factors have been studied in relation to prostate cancer; however, most studies have not reported on subtypes of fruit and vegetables or tumor characteristics, and results obtained so far are inconclusive. This study aimed to examine the prospective association of total and subtypes of fruit and vegetable intake with the incidence of prostate cancer overall, by grade and stage of disease, and prostate cancer death. Lifestyle information for 142,239 men participating in the European Prospective Investigation into Cancer and Nutrition from 8 European countries was collected at baseline. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average follow-up time of 13.9 years, 7,036 prostate cancer cases were identified. Compared with the lowest fifth, those in the highest fifth of total fruit intake had a significantly reduced prostate cancer risk (HR = 0.91; 95% CI = 0.83-0.99; p-trend = 0.01). No associations between fruit subtypes and prostate cancer risk were observed, except for citrus fruits, where a significant trend was found (HR = 0.94; 95% CI = 0.86-1.02; p-trend = 0.01). No associations between total and subtypes of vegetables and prostate cancer risk were observed. We found no evidence of heterogeneity in these associations by tumor grade and stage, with the exception of significant heterogeneity by tumor grade (p(heterogeneity)<0.001) for leafy vegetables. No significant associations with prostate cancer death were observed. The main finding of this prospective study was that a higher fruit intake was associated with a small reduction in prostate cancer risk. Whether this association is causal remains unclear. What's new? The role of diet in prostate-cancer etiology is uncertain, and associations may vary by tumor characteristics. In this prospective, longitudinal study, the authors examined the association of total and subtypes of fruit and vegetable intake with the overall incidence of prostate cancer. They then analyzed incidence by grade, stage of disease, and prostate-cancer death. They found that higher fruit intake was associated with a small reduction in prostate cancer risk, and that this association did not differ by tumor characteristics.
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