Fruit and vegetable consumption and risk of epithelial ovarian cancer: the European Prospective Investigation into Cancer and Nutrition.
Schulz M., Lahmann PH., Boeing H., Hoffmann K., Allen N., Key TJ., Bingham S., Wirfält E., Berglund G., Lundin E., Hallmans G., Lukanova A., Martínez Garcia C., González CA., Tormo MJ., Quirós JR., Ardanaz E., Larrañaga N., Lund E., Gram IT., Skeie G., Peeters PH., van Gils CH., Bueno-de-Mesquita HB., Büchner FL., Pasanisi P., Galasso R., Palli D., Tumino R., Vineis P., Trichopoulou A., Kalapothaki V., Trichopoulos D., Chang-Claude J., Linseisen J., Boutron-Ruault MC., Touillaud M., Clavel-Chapelon F., Olsen A., Tjønneland A., Overvad K., Tetsche M., Jenab M., Norat T., Kaaks R., Riboli E.
OBJECTIVE: The association between consumption of fruit and vegetables and risk of ovarian cancer is still unclear from a prospective point of view. METHODS: Female participants (n = 325,640) of the European Prospective Investigation into Cancer and Nutrition study, free of any cancer at baseline, were followed on average for 6.3 years to develop ovarian cancer. During 2,049,346 person-years, 581 verified cases of primary, invasive epithelial ovarian cancer were accrued. Consumption of fruits and vegetables as well as subgroups of vegetables, estimated from validated dietary questionnaires and calibrated thereafter, was related to ovarian cancer incidence in multivariable hazard regression models. Histologic subtype specific analyses were done. RESULTS: Total intake of fruit and vegetables, separately or combined, as well as subgroups of vegetables (fruiting, root, leafy vegetables, cabbages) was unrelated to risk of ovarian cancer. A high intake of garlic/onion vegetables was associated with a borderline significant reduced risk of this cancer. The examination by histologic subtype indicated some differential effects of fruit and vegetable intake on ovarian cancer risk. CONCLUSION: Overall, a high intake of fruits and vegetables did not seem to protect from ovarian cancer. Garlic/onion vegetables may exert a beneficial effect. The study of the histologic subtype of the tumor warrants further investigation.