Büchner Frederike L, Bueno-de-Mesquita H Bas, Ros Martine M, Kampman Ellen, Egevad Lars, Overvad Kim, Raaschou-Nielsen Ole, Tjønneland Anne, Roswall Nina, Clavel-Chapelon Francoise, Boutron-Ruault Marie-Christine, Touillaud Marina, Chang-Claude Jenny, Kaaks Rudolf, Boeing Heiner, Weikert Steffen, Trichopoulou Antonia, Lagiou Pagona, Trichopoulos Dimitrios, Palli Domenico, Sieri Sabina, Vineis Paolo, Tumino Rosario, Panico Salvatore, Vrieling Alina, Peeters Petra H M, van Gils Carla H, Lund Eiliv, Gram Inger T, Engeset Dagrun, Martinez Carmen, Gonzalez Carlos A, Larrañaga Nerea, Ardanaz Eva, Navarro Carmen, Rodríguez Laudina, Manjer Jonas, Ehrnström Roy A, Hallmans Goran, Ljungberg Borje, Allen Naomi E, Roddam Andrew W, Bingham Sheila, Khaw Kay-Tee, Slimani Nadia, Boffetta Paolo, Jenab Mazda, Mouw Traci, Michaud Dominique S, Kiemeney Lambertus A L M, Riboli Elio
The National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Int J Cancer. 2009 Dec 1;125(11):2643-51. doi: 10.1002/ijc.24582.
Previous epidemiologic studies found inconsistent associations between vegetables and fruit consumption and the risk of bladder cancer. We therefore investigated the association between vegetable and fruit consumption and the risk of bladder cancer among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Data on food consumption and complete follow-up for cancer occurrence was available for a total of 478,533 participants, who were recruited in 10 European countries. Estimates of rate ratios were obtained by Cox proportional hazard models, stratified by age at recruitment, gender and study centre, and adjusted for total energy intake, smoking status, duration of smoking and lifetime intensity of smoking. A calibration study in a subsample was used to control for dietary measurement errors. After a mean follow-up of 8.7 years, 1015 participants were newly diagnosed with bladder cancer. Increments of 100 g/day in fruit and vegetable consumption combined did not affect bladder cancer risk (i.e., calibrated HR = 0.98; 95%CI: 0.95-1.01). Borderline statistically significant lower bladder cancer risks were found among never smokers with increased consumption of fruit and vegetables combined (HR = 0.94 95%CI: 0.87-1.00 with increments of 100 g/day; calibrated HR = 0.92 95%CI 0.79-1.06) and increased consumption of apples and pears (hard fruit; calibrated HR = 0.90 95%CI: 0.82-0.98 with increments of 25 g/day). For none of the associations a statistically significant interaction with smoking status was found. Our findings do not support an effect of fruit and vegetable consumption, combined or separately, on bladder cancer risk.
以往的流行病学研究发现，蔬菜和水果的摄入量与膀胱癌风险之间的关联并不一致。因此，我们在欧洲癌症与营养前瞻性调查（EPIC）研究的参与者中，调查了蔬菜和水果摄入量与膀胱癌风险之间的关联。共有478533名参与者提供了食物消费数据以及癌症发生情况的完整随访信息，这些参与者来自10个欧洲国家。通过Cox比例风险模型获得率比估计值，按招募时的年龄、性别和研究中心进行分层，并对总能量摄入、吸烟状况、吸烟持续时间和终生吸烟强度进行校正。在一个子样本中进行校准研究，以控制饮食测量误差。平均随访8.7年后，1015名参与者被新诊断出患有膀胱癌。水果和蔬菜的摄入量联合增加100克/天，并未影响膀胱癌风险（即校准后的风险比=0.98；95%置信区间：0.95-1.01）。在从不吸烟者中，水果和蔬菜摄入量联合增加时，发现膀胱癌风险有边缘性统计学显著降低（风险比=0.94，95%置信区间：0.87-1.00，摄入量增加100克/天；校准后的风险比=0.92，95%置信区间：0.79-1.06），苹果和梨（硬水果）摄入量增加时也有类似情况（校准后的风险比=0.90，95%置信区间：0.82-0.98，摄入量增加25克/天）。对于所有这些关联，均未发现与吸烟状况有统计学显著的相互作用。我们的研究结果不支持水果和蔬菜的摄入量，无论是联合摄入还是单独摄入，对膀胱癌风险有影响。
