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Fruit and Vegetable Consumption and Risk of Epithelial Ovarian Cancer: The European Prospective Investigation into Cancer and Nutrition

¹ Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; ² Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, United Kingdom; ³ Medical Research Council Dunn Human Nutrition Unit, Cambridge, United Kingdom; ⁴ Department of Medicine, Lund University, Malmö University Hospital, Malmö, Sweden; Departments of ⁵ Biomedical Sciences/Pathology and ⁶ Public Health and Clinical Medicine/Nutritional Research, University of Umeå, Umeå, Sweden; ⁷ Department of Obstetrics and Gynecology/Epidemiology, New York University, New York, New York; ⁸ Andalusian School of Public Health, Granada, Spain; ⁹ Department of Epidemiology, Catalan Institute of Oncology, Barcelona, Spain; ¹⁰ Epidemiology Department, Health Council of Murcia, Murcia, Spain; ¹¹ Public Health and Health Planning Directorate, Asturias, Spain; ¹² Public Health Institute, Navarra, Spain; ¹³ Department of Public Health of Guipuzkoa, San Sebastian, Spain; ¹⁴ Department of Preventive Medicine, Institute of Community Medicine, University of Tromsø, Tromsø, Norway; ¹⁵ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; ¹⁶ National Institute for Public Health and the Environment, Bilthoven, The Netherlands; ¹⁷ Department of Preventive and Predictive Medicine, Istituto Nazionale Tumori, Milan, Italy; ¹⁸ Ospedale Oncologico Regionale, Rionero in Vulture, Italy; ¹⁹ Molecular and Nutritional Epidemiology Unit, Center for Cancer Research and Prevention, Scientific Institute of Tuscany, Florence, Italy; ²⁰ Cancer Registry, Azienda Ospedaliera "Civile M.P. Arezzo," Ragusa, Italy; ²¹ Cancer Epidemiology Unit, University of Turin, Turin, Italy; ²² Imperial College London, London, United Kingdom; ²³ Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Athens, Greece; ²⁴ German Cancer Research Center, Heidelberg, Germany; ²⁵ Institut National de la Santé et de la Recherche Médicale, U521, Institute Gustave Roussy, Villejuif, France; ²⁶ Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; ²⁷ Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark; and ²⁸ IARC, Lyon, France

Requests for reprints: Mandy Schulz, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14458 Nuthetal, Germany. Phone: 49-33-200-88-717; Fax: 49-33-200-88-721. E-mail: mschulz{at}mail.dife.de

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.

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