Christina C. Dahm

Variety in Fruit and Vegetable Consumption and the Risk of Lung Cancer in the European Prospective Investigation into Cancer and Nutrition

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  • Frederike L Büchner, Denmark
  • H Bas Bueno-de-Mesquita, Denmark
  • Martine M Ros, Denmark
  • Kim Overvad
  • Christina C Dahm
  • Louise Hansen, Denmark
  • Anne Tjønneland, Denmark
  • Françoise Clavel-Chapelon, Denmark
  • Marie-Christine Boutron-Ruault, Denmark
  • Marina Touillaud, Denmark
  • Rudolf Kaaks, Denmark
  • Sabine Rohrmann, Denmark
  • Heiner Boeing, Denmark
  • Ute Nöthlings, Denmark
  • Antonia Trichopoulou, Denmark
  • Dimosthenis Zylis, Denmark
  • Vardis Dilis, Denmark
  • Domenico Palli, Denmark
  • Sabina Sieri, Denmark
  • Paolo Vineis, Denmark
  • Rosario Tumino, Denmark
  • Salvatore Panico, Denmark
  • Petra H M Peeters, Denmark
  • Carla H van Gils, Denmark
  • Eiliv Lund, Denmark
  • Inger T Gram, Denmark
  • Tonje Braaten, Denmark
  • María-José Sánchez, Denmark
  • Antonio Agudo, Denmark
  • Nerea Larrañaga, Denmark
  • Eva Ardanaz, Denmark
  • Carmen Navarro, Denmark
  • Marcial V Argüelles, Denmark
  • Jonas Manjer, Denmark
  • Elisabet Wirfält, Denmark
  • Göran Hallmans, Denmark
  • Torgny Rasmuson, Denmark
  • Tim J Key, Denmark
  • Kay-Tee Khaw, Denmark
  • Nick Wareham, Denmark
  • Nadia Slimani, Denmark
  • Anne-Claire Vergnaud, Denmark
  • Wei W Xun, Denmark
  • Lambertus A L M Kiemeney, Denmark
  • Elio Riboli, Denmark
  • Institute of Epidemiology and Social Medicine
  • Klinisk Epidemiologisk Afdeling, Aalborg
BACKGROUND: We investigated whether a varied consumption of vegetables and fruits is associated with lower lung cancer risk in the European Prospective Investigation into Cancer and Nutrition study. METHODS: After a mean follow-up of 8.7 years, 1,613 of 452,187 participants with complete information were diagnosed with lung cancer. Diet diversity scores (DDS) were used to quantify the variety in fruit and vegetable consumption. Multivariable proportional hazards models were used to assess the associations between DDS and lung cancer risk. All models were adjusted for smoking behavior and the total consumption of fruit and vegetables. RESULTS: With increasing variety in vegetable subgroups, risk of lung cancer decreases [hazard ratios (HR), 0.77; 95% confidence interval (CI), 0.64-0.94 highest versus lowest quartile; P trend = 0.02]. This inverse association is restricted to current smokers (HR, 0.73; 95% CI, 0.57-0.93 highest versus lowest quartile; P trend = 0.03). In continuous analyses, in current smokers, lower risks were observed for squamous cell carcinomas with more variety in fruit and vegetable products combined (HR/two products, 0.88; 95% CI, 0.82-0.95), vegetable subgroups (HR/subgroup, 0.88; 95% CI, 0.79-0.97), vegetable products (HR/two products, 0.87; 95% CI, 0.79-0.96), and fruit products (HR/two products, 0.84; 95% CI, 0.72-0.97). CONCLUSION: Variety in vegetable consumption was inversely associated with lung cancer risk among current smokers. Risk of squamous cell carcinomas was reduced with increasing variety in fruit and/or vegetable consumption, which was mainly driven by the effect in current smokers. Impact: Independent from quantity of consumption, variety in fruit and vegetable consumption may decrease lung cancer risk. Cancer Epidemiol Biomarkers Prev; 19(9); 2278-86. (c)2010 AACR.
Original languageEnglish
JournalCancer Epidemiology, Biomarkers & Prevention
Volume19
Issue9
Pages (from-to)2278-86
ISSN1055-9965
DOIs
Publication statusPublished - 2010

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