Processed and raw tomato consumption and risk of prostate cancer: a systematic review and dose-response meta-analysis

Background Prostate cancer (PCa) is the second most frequently diagnosed cancer among men worldwide. Many epidemiological studies have found an inverse association between increased tomato consumption and PCa risk. This study aims to determine the associations between consumption of various types of tomato products and PCa risk and to investigate potential dose-response relationships. Methods We conducted a systematic review and dose-response meta-analysis of dietary tomato in relation to PCa. Eligible studies were published before April 10, 2017 and were identified from PubMed, Web of Science, and the Cochrane Library. We estimated pooled risk ratios (RRs) and 95% confidence intervals (CI) using random and fixed effects models. Linear and nonlinear dose-response relationships were also evaluated for PCa risk. Results Thirty studies related to tomato consumption and PCa risk were included in the meta-analysis, which summarized data from 24,222 cases and 260,461 participants. Higher total tomato consumption was associated with a reduced risk of PCa (RR = 0.81, 95% CI: 0.71-0.92, p = 0.001). Specifically, tomato foods (RR = 0.84, 95% CI: 0.72-0.98, p = 0.030) and cooked tomatoes and sauces (RR = 0.84, 95% CI: 0.73-0.98, p = 0.029) were associated with a reduced risk of PCa. However, no associations were found for raw tomatoes (RR = 0.96, 95% CI: 0.84-1.09, p = 0.487). There was a significant dose-response association observed for total tomato consumption (p = 0.040), cooked tomatoes and sauces (p < 0.001), and raw tomatoes (p = 0.037), but there was not a significant association with tomato foods (p(linear) = 0.511, p(nonlinear) = 0.289). Conclusions Our data demonstrate that increased tomato consumption is inversely associated with PCa risk. These findings were accompanied with dose-response relationships for total tomato consumption and for cooked tomatoes and sauces. Further studies are required to determine the underlying mechanisms of these associations.