Prospective study of vegetable consumption and liver cancer in Japan

Abstract

We examined the relationship between vegetable consumption and the risk of death from liver cancer in a cohort study in Japan. This analysis is based on data from 6,049 subjects aged 40 to 79 years enrolled in a cohort study conducted in Fukuoka Prefecture, Japan. The follow-up period was from 1986 to 1999. All liver cancer deaths were recorded. The vegetable consumption was classified into 3 groups: ''once per week or less,'' ''2-4 times per week'' and ''daily intake.'' The Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence interval (95% CI). A total of 51 male and 22 female liver cancer deaths were recorded during 62,343 person-years of follow-up. The ''once per week or less'' group was considered the referent group. In males, the multivariate HRs of liver cancer deaths were 0.61 (95% CI: 0.33-1.14) and 0.25 (95% CI: 0.11-0.59) in the ''2-4 times per week'' and ''daily intake'' groups, respectively. In females, the multivariate HRs were 0.44 (95% CI: 0.13-1.51) and 0.51 (95% CI: 0.16-1.69), respectively. The multivariate HRs were also reported by history of hepatitis and cirrhosis. In those without a history of these conditions, the multivariate HRs were 0.54 (95% CI: 0.27-1.09) and 0.36 (95% CI: 0.16-0.83). In those with a history of these conditions, the multivariate HRs were 0.58 (95% CI: 0.22-1.56) and 0.37 (95% CI: 0.13-1.06), respectively. Our study reveals an inverse association between vegetable consumption and the risk of death from liver cancer. These results provide further evidence of the protective effect of vegetables against liver cancer. ' 2006 Wiley-Liss, Inc.Key words: liver cancer; mortality; vegetable; cohort study Liver cancer is one of the malignancies for which the major etiologic factors have been well established. Among these, chronic infection with either hepatitis B virus (HBV) or hepatitis C virus (HCV) has been well documented as a major cause. 1-3 Infection either with HBV or HCV increases the risk of this cancer more than 10-fold. 4 Many other possible etiologic factors, including exposure to excessive alcohol consumption, dietary aflatoxin, diabetes mellitus, cirrhosis of any etiology and others, have been shown to play a role in the development of this cancer. 1,5 A large number of epidemiological studies have been conducted to examine the relationship of high intake of vegetables with a wide range of cancers. 6,7 In 1997, an international review panel (World Cancer Research Fund) 8 reviewed the results of published studies and reported that diets high in vegetables were considered to decrease the risk of most cancer sites. With regard to liver cancer, however, we have identified only a few studies, which examined the association between vegetable consumption and liver cancer, and the results of these were inconsistent. 9-12 To contribute to clarifying this relationship, we conducted this study to investigate the association between vegetable consumption and liver cancer mortality, based on a population-based prospective cohort study in...

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