Subtypes of fruit and vegetables, variety in consumption and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition

Abstract

Previously, a lower risk of colorectal cancer was observed with fruit and vegetable consumption in the European Prospective Investigation into Cancer and Nutrition within a follow-up period of 9 years which was not fully supported by a recent meta-analysis. Therefore, we were interested in the relation with extended follow-up, also focusing on single subtypes and a variety of intake of fruit and vegetables. Fruit and vegetable consumption was assessed at baseline. After an average of 13 years of follow-up, 3,370 participants were diagnosed with colon or rectal cancer. Diet diversity scores were constructed to quantify variety in fruit and vegetable consumption. A lower risk of colon cancer was observed with higher self-reported consumption of fruit and vegetable combined (HR Q4 vs. Q1 0.87, 95% CI 0.75–1.01, p for trend 0.02), but no consistent association was observed for separate consumption of fruits and vegetables. No associations with risk of rectal cancer were observed. The few observed associations for some fruit and vegetable subtypes with colon cancer risk may have been due to chance. Variety in consumption of fruits and vegetables was not associated with a lower risk of colon or rectal cancer. Although a lower risk of colon cancer is suggested with high consumption of fruit and vegetables, this study does not support a clear inverse association between fruit and vegetable consumption and colon or rectal cancer beyond a follow-up of more than 10 years. Attenuation of the risk estimates from dietary changes over time cannot be excluded, but appears unlikely

Colors of vegetables and fruits and the risks of colorectal cancer

“…However, recent cohort studies[13,14,23,29], and a recent case- control study[12], do not comply with our results.…”

Fruit and vegetable consumption,Helicobacter pyloriantibodies, and gastric cancer risk: A pooled analysis of prospective studies in China, Japan, and Korea

“…Citrus intake, specifically, has been found to be associated with reduced risk of esophageal cancer (OR = 0.63, 95% CI: 0.52–0.75) . However, the association between fruit and vegetable consumption and colon or rectal cancer was not found in an European study with >10‐year follow‐up …”

“…43 However, the association between fruit and vegetable consumption and colon or rectal cancer was not found in an European study with >10-year follow-up. 44 There are a number of limitations to the present analyses. The follow-up time in this study was relatively short (median follow-up time, 6.2 years).…”

Colorectal cancer: a review

“…31 Survival ranges are significantly different by stage, 90% for localized disease, 68% for regional disease with lymphatic affection, and 10% for disseminated disease related to the early detection unlike other types of cancer in which the size of the tumor does not affect the prognosis of the disease; however the increase in the mortality rate is justified in the increase of the life expectancy in the population, in the relation of the increase of genetic alterations due to greater susceptibility to carcinogenic, immunosuppression and comorbidity of the patients which explains the greatest risk of developing colorectal cancer. 33 Mortality rates are variable in terms of gender, with a very slight prevalence of female sex, in colon cancer (51 vs 49%), and male sex in colorectal cancer (53 vs 46), mainly by liver metastases as a leading cause of death in these patients. 2 Approximately 50-60% of the patients diagnosed will develop metastasis.…”