Fruits, vegetables and lung cancer: a pooled analysis of cohort studies

S.A. Smith-Warner, D. Spiegelman, S. Yaun, D. Albanes, W.L. Beeson, P.A. van den Brandt, D. Feskanich, A.R. Folsom, G.E. Fraser, J.L. Freudenheim, E. Giovannucci, R.A. Goldbohm, S. Graham, L.H. Kushi, A.B. Miller, P. Pietinen, T.E. Rohan, F.E. Speizer, W.C. Willett, D.J. Hunter

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Abstract

Fruits, vegetables and lung cancer: a pooled analysis of cohort studies.

Smith-Warner SA, Spiegelman D, Yaun SS, Albanes D, Beeson WL, van den Brandt PA, Feskanich D, Folsom AR, Fraser GE, Freudenheim JL, Giovannucci E, Goldbohm RA, Graham S, Kushi LH, Miller AB, Pietinen P, Rohan TE, Speizer FE, Willett WC, Hunter DJ.

Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.

Inverse associations between fruit and vegetable consumption and lung cancer risk have been consistently reported. However, identifying the specific fruits and vegetables associated with lung cancer is difficult because the food groups and foods evaluated have varied across studies. We analyzed fruit and vegetable groups using standardized exposure and covariate definitions in 8 prospective studies. We combined study-specific relative risks (RRs) using a random effects model. In the pooled database, 3,206 incident lung cancer cases occurred among 430,281 women and men followed for up to 6-16 years across studies. Controlling for smoking habits and other lung cancer risk factors, a 16-23% reduction in lung cancer risk was observed for quintiles 2 through 5 vs. the lowest quintile of consumption for total fruits (RR = 0.77; 95% CI = 0.67-0.87 for quintile 5; p-value, test for trend < 0.001) and for total fruits and vegetables (RR = 0.79; 95% CI = 0.69-0.90; p-value, test for trend = 0.001). For the same comparison, the association was weaker for total vegetable consumption (RR = 0.88; 95% CI = 0.78-1.00; p-value, test for trend = 0.12). Associations were similar between never, past, and current smokers. These results suggest that elevated fruit and vegetable consumption is associated with a modest reduction in lung cancer risk, which is mostly attributable to fruit, not vegetable, intake. However, we cannot rule out the possibility that our results are due to residual confounding by smoking. The primary focus for reducing lung cancer incidence should continue to be smoking prevention and cessation. Copyright 2003 Wiley-Liss, Inc.
Original languageEnglish
Pages (from-to)1001-1011
Number of pages11
JournalInternational Journal of Cancer
Volume107
Issue number6
DOIs
Publication statusPublished - 1 Jan 2003

Cite this

Smith-Warner, S. A., Spiegelman, D., Yaun, S., Albanes, D., Beeson, W. L., van den Brandt, P. A., ... Hunter, D. J. (2003). Fruits, vegetables and lung cancer: a pooled analysis of cohort studies. International Journal of Cancer, 107(6), 1001-1011. https://doi.org/10.1002/ijc.11490
Smith-Warner, S.A. ; Spiegelman, D. ; Yaun, S. ; Albanes, D. ; Beeson, W.L. ; van den Brandt, P.A. ; Feskanich, D. ; Folsom, A.R. ; Fraser, G.E. ; Freudenheim, J.L. ; Giovannucci, E. ; Goldbohm, R.A. ; Graham, S. ; Kushi, L.H. ; Miller, A.B. ; Pietinen, P. ; Rohan, T.E. ; Speizer, F.E. ; Willett, W.C. ; Hunter, D.J. / Fruits, vegetables and lung cancer: a pooled analysis of cohort studies. In: International Journal of Cancer. 2003 ; Vol. 107, No. 6. pp. 1001-1011.
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abstract = "Fruits, vegetables and lung cancer: a pooled analysis of cohort studies.Smith-Warner SA, Spiegelman D, Yaun SS, Albanes D, Beeson WL, van den Brandt PA, Feskanich D, Folsom AR, Fraser GE, Freudenheim JL, Giovannucci E, Goldbohm RA, Graham S, Kushi LH, Miller AB, Pietinen P, Rohan TE, Speizer FE, Willett WC, Hunter DJ.Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.Inverse associations between fruit and vegetable consumption and lung cancer risk have been consistently reported. However, identifying the specific fruits and vegetables associated with lung cancer is difficult because the food groups and foods evaluated have varied across studies. We analyzed fruit and vegetable groups using standardized exposure and covariate definitions in 8 prospective studies. We combined study-specific relative risks (RRs) using a random effects model. In the pooled database, 3,206 incident lung cancer cases occurred among 430,281 women and men followed for up to 6-16 years across studies. Controlling for smoking habits and other lung cancer risk factors, a 16-23{\%} reduction in lung cancer risk was observed for quintiles 2 through 5 vs. the lowest quintile of consumption for total fruits (RR = 0.77; 95{\%} CI = 0.67-0.87 for quintile 5; p-value, test for trend < 0.001) and for total fruits and vegetables (RR = 0.79; 95{\%} CI = 0.69-0.90; p-value, test for trend = 0.001). For the same comparison, the association was weaker for total vegetable consumption (RR = 0.88; 95{\%} CI = 0.78-1.00; p-value, test for trend = 0.12). Associations were similar between never, past, and current smokers. These results suggest that elevated fruit and vegetable consumption is associated with a modest reduction in lung cancer risk, which is mostly attributable to fruit, not vegetable, intake. However, we cannot rule out the possibility that our results are due to residual confounding by smoking. The primary focus for reducing lung cancer incidence should continue to be smoking prevention and cessation. Copyright 2003 Wiley-Liss, Inc.",
author = "S.A. Smith-Warner and D. Spiegelman and S. Yaun and D. Albanes and W.L. Beeson and {van den Brandt}, P.A. and D. Feskanich and A.R. Folsom and G.E. Fraser and J.L. Freudenheim and E. Giovannucci and R.A. Goldbohm and S. Graham and L.H. Kushi and A.B. Miller and P. Pietinen and T.E. Rohan and F.E. Speizer and W.C. Willett and D.J. Hunter",
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Smith-Warner, SA, Spiegelman, D, Yaun, S, Albanes, D, Beeson, WL, van den Brandt, PA, Feskanich, D, Folsom, AR, Fraser, GE, Freudenheim, JL, Giovannucci, E, Goldbohm, RA, Graham, S, Kushi, LH, Miller, AB, Pietinen, P, Rohan, TE, Speizer, FE, Willett, WC & Hunter, DJ 2003, 'Fruits, vegetables and lung cancer: a pooled analysis of cohort studies', International Journal of Cancer, vol. 107, no. 6, pp. 1001-1011. https://doi.org/10.1002/ijc.11490

Fruits, vegetables and lung cancer: a pooled analysis of cohort studies. / Smith-Warner, S.A.; Spiegelman, D.; Yaun, S.; Albanes, D.; Beeson, W.L.; van den Brandt, P.A.; Feskanich, D.; Folsom, A.R.; Fraser, G.E.; Freudenheim, J.L.; Giovannucci, E.; Goldbohm, R.A.; Graham, S.; Kushi, L.H.; Miller, A.B.; Pietinen, P.; Rohan, T.E.; Speizer, F.E.; Willett, W.C.; Hunter, D.J.

In: International Journal of Cancer, Vol. 107, No. 6, 01.01.2003, p. 1001-1011.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Fruits, vegetables and lung cancer: a pooled analysis of cohort studies

AU - Smith-Warner, S.A.

AU - Spiegelman, D.

AU - Yaun, S.

AU - Albanes, D.

AU - Beeson, W.L.

AU - van den Brandt, P.A.

AU - Feskanich, D.

AU - Folsom, A.R.

AU - Fraser, G.E.

AU - Freudenheim, J.L.

AU - Giovannucci, E.

AU - Goldbohm, R.A.

AU - Graham, S.

AU - Kushi, L.H.

AU - Miller, A.B.

AU - Pietinen, P.

AU - Rohan, T.E.

AU - Speizer, F.E.

AU - Willett, W.C.

AU - Hunter, D.J.

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N2 - Fruits, vegetables and lung cancer: a pooled analysis of cohort studies.Smith-Warner SA, Spiegelman D, Yaun SS, Albanes D, Beeson WL, van den Brandt PA, Feskanich D, Folsom AR, Fraser GE, Freudenheim JL, Giovannucci E, Goldbohm RA, Graham S, Kushi LH, Miller AB, Pietinen P, Rohan TE, Speizer FE, Willett WC, Hunter DJ.Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.Inverse associations between fruit and vegetable consumption and lung cancer risk have been consistently reported. However, identifying the specific fruits and vegetables associated with lung cancer is difficult because the food groups and foods evaluated have varied across studies. We analyzed fruit and vegetable groups using standardized exposure and covariate definitions in 8 prospective studies. We combined study-specific relative risks (RRs) using a random effects model. In the pooled database, 3,206 incident lung cancer cases occurred among 430,281 women and men followed for up to 6-16 years across studies. Controlling for smoking habits and other lung cancer risk factors, a 16-23% reduction in lung cancer risk was observed for quintiles 2 through 5 vs. the lowest quintile of consumption for total fruits (RR = 0.77; 95% CI = 0.67-0.87 for quintile 5; p-value, test for trend < 0.001) and for total fruits and vegetables (RR = 0.79; 95% CI = 0.69-0.90; p-value, test for trend = 0.001). For the same comparison, the association was weaker for total vegetable consumption (RR = 0.88; 95% CI = 0.78-1.00; p-value, test for trend = 0.12). Associations were similar between never, past, and current smokers. These results suggest that elevated fruit and vegetable consumption is associated with a modest reduction in lung cancer risk, which is mostly attributable to fruit, not vegetable, intake. However, we cannot rule out the possibility that our results are due to residual confounding by smoking. The primary focus for reducing lung cancer incidence should continue to be smoking prevention and cessation. Copyright 2003 Wiley-Liss, Inc.

AB - Fruits, vegetables and lung cancer: a pooled analysis of cohort studies.Smith-Warner SA, Spiegelman D, Yaun SS, Albanes D, Beeson WL, van den Brandt PA, Feskanich D, Folsom AR, Fraser GE, Freudenheim JL, Giovannucci E, Goldbohm RA, Graham S, Kushi LH, Miller AB, Pietinen P, Rohan TE, Speizer FE, Willett WC, Hunter DJ.Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.Inverse associations between fruit and vegetable consumption and lung cancer risk have been consistently reported. However, identifying the specific fruits and vegetables associated with lung cancer is difficult because the food groups and foods evaluated have varied across studies. We analyzed fruit and vegetable groups using standardized exposure and covariate definitions in 8 prospective studies. We combined study-specific relative risks (RRs) using a random effects model. In the pooled database, 3,206 incident lung cancer cases occurred among 430,281 women and men followed for up to 6-16 years across studies. Controlling for smoking habits and other lung cancer risk factors, a 16-23% reduction in lung cancer risk was observed for quintiles 2 through 5 vs. the lowest quintile of consumption for total fruits (RR = 0.77; 95% CI = 0.67-0.87 for quintile 5; p-value, test for trend < 0.001) and for total fruits and vegetables (RR = 0.79; 95% CI = 0.69-0.90; p-value, test for trend = 0.001). For the same comparison, the association was weaker for total vegetable consumption (RR = 0.88; 95% CI = 0.78-1.00; p-value, test for trend = 0.12). Associations were similar between never, past, and current smokers. These results suggest that elevated fruit and vegetable consumption is associated with a modest reduction in lung cancer risk, which is mostly attributable to fruit, not vegetable, intake. However, we cannot rule out the possibility that our results are due to residual confounding by smoking. The primary focus for reducing lung cancer incidence should continue to be smoking prevention and cessation. Copyright 2003 Wiley-Liss, Inc.

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