Intakes of Fruit, Vegetables, and Carotenoids and Renal Cell Cancer Risk: A Pooled Analysis of 13 Prospective Studies
- Jung Eun Lee1,
- Satu Männistö6,
- Donna Spiegelman3,5,
- David J. Hunter1,3,4,
- Leslie Bernstein7,
- Piet A. van den Brandt8,
- Julie E. Buring2,3,
- Eunyoung Cho1,4,
- Dallas R. English9,
- Andrew Flood10,
- Jo L. Freudenheim12,
- Graham G. Giles9,
- Edward Giovannucci1,3,4,
- Niclas Håkansson14,
- Pamela L. Horn-Ross15,
- Eric J. Jacobs16,
- Michael F. Leitzmann17,
- James R. Marshall13,
- Marjorie L. McCullough16,
- Anthony B. Miller18,
- Thomas E. Rohan19,
- Julie A. Ross11,
- Arthur Schatzkin20,
- Leo J. Schouten8,
- Jarmo Virtamo6,
- Alicja Wolk14,
- Shumin M. Zhang2 and
- Stephanie A. Smith-Warner3,4
- 1Channing Laboratory, and 2Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; 3Departments of Epidemiology, 4Nutrition, and 5Biostatistics, Harvard School of Public Health, Boston, Massachusetts; 6National Institute for Health and Welfare, Helsinki, Finland; 7City of Hope Comprehensive Cancer Center and Beckman Research Institute, City of Hope National Medical Center, Duarte, California; 8Department of Epidemiology, GROW-School for Oncology and Developmental Biology, University Maastricht, Maastricht, the Netherlands; 9Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia; 10Division of Epidemiology and Community Health, School of Public Health, and 11Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; 12Department of Social and Preventive Medicine, University at Buffalo, State University of New York; 13Roswell Park Cancer Institute, Buffalo, New York; 14Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; 15Northern California Cancer Center, Fremont, California; 16Epidemiology and Surveillance Research, American Cancer Society, Atlanta, Georgia; 17Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany; 18Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; 19Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and 20Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Health Services, Bethesda, Maryland
- Requests for reprints:
Jung Eun Lee, Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115. Phone: 617-525-2042; Fax: 617-525-2008. E-mail: jung.lee{at}channing.harvard.edu
Abstract
Fruit and vegetable consumption has been hypothesized to reduce the risk of renal cell cancer. We conducted a pooled analysis of 13 prospective studies, including 1,478 incident cases of renal cell cancer (709 women and 769 men) among 530,469 women and 244,483 men followed for up to 7 to 20 years. Participants completed a validated food-frequency questionnaire at baseline. Using the primary data from each study, the study-specific relative risks (RR) were calculated using the Cox proportional hazards model and then pooled using a random effects model. We found that fruit and vegetable consumption was associated with a reduced risk of renal cell cancer. Compared with <200 g/d of fruit and vegetable intake, the pooled multivariate RR for ≥600 g/d was 0.68 [95% confidence interval (95% CI) = 0.54-0.87; P for between-studies heterogeneity = 0.86; P for trend = 0.001]. Compared with <100 g/d, the pooled multivariate RRs (95% CI) for ≥400 g/d were 0.79 (0.63-0.99; P for trend = 0.03) for total fruit and 0.72 (0.48-1.08; P for trend = 0.07) for total vegetables. For specific carotenoids, the pooled multivariate RRs (95% CIs) comparing the highest and lowest quintiles were 0.87 (0.73-1.03) for α-carotene, 0.82 (0.69-0.98) for β-carotene, 0.86 (0.73-1.01) for β-cryptoxanthin, 0.82 (0.64-1.06) for lutein/zeaxanthin, and 1.13 (0.95-1.34) for lycopene. In conclusion, increasing fruit and vegetable consumption is associated with decreasing risk of renal cell cancer; carotenoids present in fruit and vegetables may partly contribute to this protection. (Cancer Epidemiol Biomarkers Prev 2009;18(6):1730–9)
Footnotes
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Grant support: The Pooling Project is supported by National Cancer Institute grant CA55075. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the NIH.
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- Accepted March 18, 2009.
- Received January 15, 2009.
- Revision received March 11, 2009.
