Fruits and vegetables consumption and the risk of histological subtypes of lung cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC).
Büchner FL., Bueno-de-Mesquita HB., Linseisen J., Boshuizen HC., Kiemeney LA., Ros MM., Overvad K., Hansen L., Tjonneland A., Raaschou-Nielsen O., Clavel-Chapelon F., Boutron-Ruault MC., Touillaud M., Kaaks R., Rohrmann S., Boeing H., Nöthlings U., Trichopoulou A., Zylis D., Dilis V., Palli D., Sieri S., Vineis P., Tumino R., Panico S., Peeters PH., van Gils CH., Lund E., Gram IT., Braaten T., Martinez C., Agudo A., Arriola L., Ardanaz E., Navarro C., Rodríguez L., Manjer J., Wirfält E., Hallmans G., Rasmuson T., Key TJ., Roddam AW., Bingham S., Khaw KT., Slimani N., Bofetta P., Byrnes G., Norat T., Michaud D., Riboli E.
OBJECTIVE: To examine the association between fruit and vegetable consumption and risk of different histological subtypes of lung cancer among participants of the European Prospective Investigation into Cancer and Nutrition study. METHODS: Multivariable Cox proportional hazard models were used to analyze the data. A calibration study in a subsample was used to reduce dietary measurement errors. RESULTS: During a mean follow-up of 8.7 years, 1,830 incident cases of lung cancer (574 adenocarcinoma, 286 small cell, 137 large cell, 363 squamous cell, 470 other histologies) were identified. In line with our previous conclusions, we found that after calibration a 100 g/day increase in fruit and vegetables consumption was associated with a reduced lung cancer risk (HR 0.94; 95% CI 0.89-0.99). This was also seen among current smokers (HR 0.93; 95% CI 0.90-0.97). Risks of squamous cell carcinomas in current smokers were reduced for an increase of 100 g/day of fruit and vegetables combined (HR 0.85; 95% CI 0.76-0.94), while no clear effects were seen for the other histological subtypes. CONCLUSION: We observed inverse associations between the consumption of vegetables and fruits and risk of lung cancer without a clear effect on specific histological subtypes of lung cancer. In current smokers, consumption of vegetables and fruits may reduce lung cancer risk, in particular the risk of squamous cell carcinomas.