Perez-Cornago Aurora, Travis Ruth C, Appleby Paul N, Tsilidis Konstantinos K, Tjønneland Anne, Olsen Anja, Overvad Kim, Katzke Verena, Kühn Tilman, Trichopoulou Antonia, Peppa Eleni, Kritikou Maria, Sieri Sabina, Palli Domenico, Sacerdote Carlotta, Tumino Rosario, Bueno-de-Mesquita H B As, Agudo Antonio, Larrañaga Nerea, Molina-Portillo Elena, Ardanaz Eva, Chirlaque Maria-Dolores, Lasheras Cristina, Stattin Pär, Wennberg Maria, Drake Isabel, Malm Johan, Schmidt Julie A, Khaw Kay-Tee, Gunter Marc, Freisling Heinz, Huybrechts Inge, Aune Dagfinn, Cross Amanda J, Riboli Elio, Key Timothy J
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
Int J Cancer. 2017 Jul 15;141(2):287-297. doi: 10.1002/ijc.30741. Epub 2017 May 15.
Several dietary factors have been studied in relation to prostate cancer; however, most studies have not reported on subtypes of fruit and vegetables or tumor characteristics, and results obtained so far are inconclusive. This study aimed to examine the prospective association of total and subtypes of fruit and vegetable intake with the incidence of prostate cancer overall, by grade and stage of disease, and prostate cancer death. Lifestyle information for 142,239 men participating in the European Prospective Investigation into Cancer and Nutrition from 8 European countries was collected at baseline. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average follow-up time of 13.9 years, 7,036 prostate cancer cases were identified. Compared with the lowest fifth, those in the highest fifth of total fruit intake had a significantly reduced prostate cancer risk (HR = 0.91; 95% CI = 0.83-0.99; p-trend = 0.01). No associations between fruit subtypes and prostate cancer risk were observed, except for citrus fruits, where a significant trend was found (HR = 0.94; 95% CI = 0.86-1.02; p-trend = 0.01). No associations between total and subtypes of vegetables and prostate cancer risk were observed. We found no evidence of heterogeneity in these associations by tumor grade and stage, with the exception of significant heterogeneity by tumor grade (p <0.001) for leafy vegetables. No significant associations with prostate cancer death were observed. The main finding of this prospective study was that a higher fruit intake was associated with a small reduction in prostate cancer risk. Whether this association is causal remains unclear.
已经对几种饮食因素与前列腺癌的关系进行了研究；然而，大多数研究并未报告水果和蔬菜的亚型或肿瘤特征，而且目前得到的结果尚无定论。本研究旨在探讨水果和蔬菜总摄入量及其亚型与前列腺癌总体发病率、疾病分级和分期以及前列腺癌死亡之间的前瞻性关联。在基线时收集了来自8个欧洲国家的142,239名参与欧洲癌症与营养前瞻性调查的男性的生活方式信息。使用多变量Cox回归模型来估计风险比（HR）和95%置信区间（CI）。经过平均13.9年的随访，共确诊7036例前列腺癌病例。与总水果摄入量最低的五分之一人群相比，总水果摄入量最高的五分之一人群患前列腺癌的风险显著降低（HR = 0.91；95% CI = 0.83 - 0.99；p趋势 = 0.01）。除柑橘类水果外，未观察到水果亚型与前列腺癌风险之间的关联，柑橘类水果呈现出显著趋势（HR = 0.94；95% CI = 0.86 - 1.02；p趋势 = 0.01）。未观察到蔬菜总摄入量及其亚型与前列腺癌风险之间的关联。我们发现这些关联在肿瘤分级和分期方面不存在异质性证据，但叶菜类蔬菜在肿瘤分级方面存在显著异质性（p < 0.001）。未观察到与前列腺癌死亡的显著关联。这项前瞻性研究的主要发现是，较高的水果摄入量与前列腺癌风险的小幅降低相关。这种关联是否具有因果关系尚不清楚。
