Fruit And Vegetable Intake And Prostate Cancer Risk In The European Prospective Investigation Into Cancer And Nutrition (EPIC)

Aurora PEREZ-CORNAGO, University of Oxford, United Kingdom
APPLEBY P. 1 , TSILIDIS K. 2,3 , RUTH T. 1 , KEY T. 1

1 Cancer Epidemiology Unit, Nuffield Department of population Health, University of Oxford, Oxford, United Kingdom.
2 Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Greece.
3 Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom.

Purpose: The aim of this study was to examine the prospective association of fruit and vegetable intake with the incidence of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). We also examined the relationships of the major fruit and vegetables subtypes with prostate cancer incidence overall and by grade and stage of disease.
Methods: Lifestyle information for 142,254 men participating in EPIC from 19 centres in 8 European countries was collected at baseline. Validated dietary questionnaires were used to estimate fruit and vegetable intake, which was calibrated using 24-hr dietary recalls. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results: After an average follow-up time of 14 years, 7,034 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=0.88; 95% CI=0.81-0.96; P trend=0.005). Among fruit subtypes (citrus fruits, apples and pears, grapes, and bananas), only citrus fruits consumption was significantly associated with lower incidence of prostate cancer (HR in the highest versus lowest fifth=0.92; 95% CI=0.85-1.00; P trend=0.006). High vegetable consumption was not associated with lower incidence of prostate cancer (HR in the highest versus lowest fifth=1.00; 95% CI=0.91-1.10; P trend=0.53). None of the subtypes of vegetables (leafy vegetables, fruiting vegetables, root vegetables and brassicas) were associated with prostate cancer risk (P trend > 0.05). No evidence of heterogeneity between low- and high-grade or between localized and advanced-stage of the disease was observed.
Conclusions: Results from this large observational study suggest that a higher intake of fruit, especially citrus fruit, is associated with a small reduction in risk of prostate cancer.
Funding  source: This work was funded by Cancer Research UK (C8221/A19170).