© 2000 by Oxford University Press
Journal of the National Cancer Institute, Vol. 92, No. 21, 1740-1752,
November 1, 2000
© 2000 Oxford University Press
Prospective Study of Fruit and Vegetable Consumption and Incidence of Colon and Rectal Cancers
Affiliations of authors: K. B. Michels, M. J. Stampfer, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, and Department of Epidemiology, Harvard School of Public Health, Boston; E. Giovannucci, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Department of Nutrition, Harvard School of Public Health, Boston; K. J. Joshipura, Department of Epidemiology, Harvard School of Public Health, and Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston; B. A. Rosner, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Department of Biostatistics, Harvard School of Public Health; C. S. Fuchs, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Department of Adult Oncology, Dana-Farber Cancer Institute, Boston; G. A. Colditz, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Department of Epidemiology and Harvard Center for Cancer Prevention, Harvard School of Public Health; F. E. Speizer, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School; W. C. Willett, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Departments of Epidemiology and Nutrition, Harvard School of Public Health.
Correspondence to: Karin B. Michels, Sc.D., Channing Laboratory, 181 Longwood Ave., Boston, MA 02115 (e-mail: kmichels{at}rics.bwh.harvard.edu).
Background: Frequent consumption of fruit and vegetables has been associated with a reduced risk of colorectal cancer in many observational studies. Methods: We prospectively investigated the association between fruit and vegetable consumption and the incidence of colon and rectal cancers in two large cohorts: the Nurses' Health Study (88 764 women) and the Health Professionals' Follow-up Study (47 325 men). Diet was assessed and cumulatively updated in 1980, 1984, 1986, and 1990 among women and in 1986 and 1990 among men. The incidence of cancer of the colon and rectum was ascertained up to June or January of 1996, respectively. Relative risk (RR) estimates were calculated with the use of pooled logistic regression models accounting for various potential confounders. All statistical tests were two-sided. Results: With a follow-up including 1 743 645 person-years and 937 cases of colon cancer, we found little association of colon cancer incidence with fruit and vegetable consumption. For women and men combined, a difference in fruit and vegetable consumption of one additional serving per day was associated with a covariate-adjusted RR of 1.02 (95% confidence interval [CI] = 0.98–1.05). A difference in vegetable consumption of one additional serving per day was associated with an RR of 1.03 (95% CI = 0.97–1.09). Similar results were obtained for women and men considered separately. A difference in fruit consumption of one additional serving per day was associated with a covariate-adjusted RR for colon cancer of 0.96 (95% CI = 0.89–1.03) among women and 1.08 (95% CI = 1.00–1.16) among men. For rectal cancer (total, 244 cases), a difference in fruit and vegetable consumption of one additional serving per day was associated with an RR of 1.02 (95% CI = 0.95–1.09) in men and women combined. None of these associations was modified by vitamin supplement use or smoking habits. Conclusions: Although fruits and vegetables may confer protection against some chronic diseases, their frequent consumption does not appear to confer protection from colon or rectal cancer.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. A. Timm and J. L. Slavin Dietary Fiber and the Relationship to Chronic Diseases American Journal of Lifestyle Medicine, June 1, 2008; 2(3): 233 - 240. [Abstract] [PDF]
|
|
|
|
 |
|
 A. E Millen, A. F Subar, B. I Graubard, U. Peters, R. B Hayes, J. L Weissfeld, L. A Yokochi, R. G Ziegler, and for the Prostate, Lung, Colorectal, and Ovarian (P Fruit and vegetable intake and prevalence of colorectal adenoma in a cancer screening trial Am. J. Clinical Nutrition, December 1, 2007; 86(6): 1754 - 1764. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Koushik, D. J. Hunter, D. Spiegelman, W. L. Beeson, P. A. van den Brandt, J. E. Buring, E. E. Calle, E. Cho, G. E. Fraser, J. L. Freudenheim, et al. Fruits, Vegetables, and Colon Cancer Risk in a Pooled Analysis of 14 Cohort Studies J Natl Cancer Inst, October 3, 2007; 99(19): 1471 - 1483. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. C. Wilms, A. W. Boots, V. C.J. de Boer, L. M. Maas, D. M.F.A. Pachen, R. W.H. Gottschalk, H. B. Ketelslegers, R. W.L. Godschalk, G. R.M.M. Haenen, F. J. van Schooten, et al. Impact of multiple genetic polymorphisms on effects of a 4-week blueberry juice intervention on ex vivo induced lymphocytic DNA damage in human volunteers Carcinogenesis, August 1, 2007; 28(8): 1800 - 1806. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Park, A. F. Subar, V. Kipnis, F. E. Thompson, T. Mouw, A. Hollenbeck, M. F. Leitzmann, and A. Schatzkin Fruit and Vegetable Intakes and Risk of Colorectal Cancer in the NIH-AARP Diet and Health Study Am. J. Epidemiol., July 15, 2007; 166(2): 170 - 180. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. L. Austin, L. S. Adair, J. A. Galanko, C. F. Martin, J. A. Satia, and R. S. Sandler A Diet High in Fruits and Low in Meats Reduces the Risk of Colorectal Adenomas J. Nutr., April 1, 2007; 137(4): 999 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Mannisto, S.-S. Yaun, D. J. Hunter, D. Spiegelman, H.-O. Adami, D. Albanes, P. A. van den Brandt, J. E. Buring, J. R. Cerhan, G. A. Colditz, et al. Dietary Carotenoids and Risk of Colorectal Cancer in a Pooled Analysis of 11 Cohort Studies Am. J. Epidemiol., February 1, 2007; 165(3): 246 - 255. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Lin, S. M. Zhang, K. Wu, W. C. Willett, C. S. Fuchs, and E. Giovannucci Flavonoid Intake and Colorectal Cancer Risk in Men and Women Am. J. Epidemiol., October 1, 2006; 164(7): 644 - 651. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. N. Maserejian, E. Giovannucci, B. Rosner, A. Zavras, and K. Joshipura Prospective Study of Fruits and Vegetables and Risk of Oral Premalignant Lesions in Men Am. J. Epidemiol., September 15, 2006; 164(6): 556 - 566. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Lanza, T. J. Hartman, P. S. Albert, R. Shields, M. Slattery, B. Caan, E. Paskett, F. Iber, J. W. Kikendall, P. Lance, et al. High Dry Bean Intake and Reduced Risk of Advanced Colorectal Adenoma Recurrence among Participants in the Polyp Prevention Trial J. Nutr., July 1, 2006; 136(7): 1896 - 1903. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Smith-Warner, D. Spiegelman, J. Ritz, D. Albanes, W. L. Beeson, L. Bernstein, F. Berrino, P. A. van den Brandt, J. E. Buring, E. Cho, et al. Methods for Pooling Results of Epidemiologic Studies: The Pooling Project of Prospective Studies of Diet and Cancer Am. J. Epidemiol., June 1, 2006; 163(11): 1053 - 1064. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. B. Michels, E. Giovannucci, A. T. Chan, R. Singhania, C. S. Fuchs, and W. C. Willett Fruit and vegetable consumption and colorectal adenomas in the Nurses' Health Study. Cancer Res., April 1, 2006; 66(7): 3942 - 3953. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Tijhuis, P. A. Wark, J. M.M.J.G. Aarts, M. H.P.W. Visker, F. M. Nagengast, F. J. Kok, and E. Kampman GSTP1 and GSTA1 Polymorphisms Interact with Cruciferous Vegetable Intake in Colorectal Adenoma Risk Cancer Epidemiol. Biomarkers Prev., December 1, 2005; 14(12): 2943 - 2951. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Mizoue, T. Yamaji, S. Tabata, K. Yamaguchi, E. Shimizu, M. Mineshita, S. Ogawa, and S. Kono Dietary Patterns and Colorectal Adenomas in Japanese Men: The Self-Defense Forces Health Study Am. J. Epidemiol., February 15, 2005; 161(4): 338 - 345. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-C. Hung, K. J. Joshipura, R. Jiang, F. B. Hu, D. Hunter, S. A. Smith-Warner, G. A. Colditz, B. Rosner, D. Spiegelman, and W. C. Willett Fruit and Vegetable Intake and Risk of Major Chronic Disease J Natl Cancer Inst, November 3, 2004; 96(21): 1577 - 1584. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Papas, E. Giovannucci, and E. A. Platz Fiber from Fruit and Colorectal Neoplasia Cancer Epidemiol. Biomarkers Prev., August 1, 2004; 13(8): 1267 - 1270. [Full Text] [PDF]
|
|
|
|
|
|
M. L Slattery, K. P Curtin, S. L Edwards, and D. M Schaffer Plant foods, fiber, and rectal cancer Am. J. Clinical Nutrition, February 1, 2004; 79(2): 274 - 281. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. W. Lee, H. J. Lee, Y.-J. Surh, and C. Y. Lee Vitamin C and cancer chemoprevention: reappraisal Am. J. Clinical Nutrition, December 1, 2003; 78(6): 1074 - 1078. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G Erhardt, C. Meisner, J C. Bode, and C. Bode Lycopene, {beta}-carotene, and colorectal adenomas Am. J. Clinical Nutrition, December 1, 2003; 78(6): 1219 - 1224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Otani, M. Iwasaki, S. Yamamoto, T. Sobue, T. Hanaoka, M. Inoue, and S. Tsugane Alcohol Consumption, Smoking, and Subsequent Risk of Colorectal Cancer in Middle-Aged and Elderly Japanese Men and Women: Japan Public Health Center-based Prospective Study Cancer Epidemiol. Biomarkers Prev., December 1, 2003; 12(12): 1492 - 1500. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Little, L. Sharp, S. Duthie, and S. Narayanan Colon Cancer and Genetic Variation in Folate Metabolism: The Clinical Bottom Line J. Nutr., November 1, 2003; 133(11): 3758S - 3766. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. M. Popkin and S. Du Dynamics of the Nutrition Transition toward the Animal Foods Sector in China and its Implications: A Worried Perspective J. Nutr., November 1, 2003; 133(11): 3898S - 3906. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Riboli and T. Norat Epidemiologic evidence of the protective effect of fruit and vegetables on cancer risk Am. J. Clinical Nutrition, September 1, 2003; 78(3): 559S - 569. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Kipnis, A. F. Subar, D. Midthune, L. S. Freedman, R. Ballard-Barbash, R. P. Troiano, S. Bingham, D. A. Schoeller, A. Schatzkin, and R. J. Carroll Structure of Dietary Measurement Error: Results of the OPEN Biomarker Study Am. J. Epidemiol., July 1, 2003; 158(1): 14 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. E. Corpet and F. Pierre Point: From Animal Models to Prevention of Colon Cancer. Systematic Review of Chemoprevention in Min Mice and Choice of the Model System Cancer Epidemiol. Biomarkers Prev., May 1, 2003; 12(5): 391 - 400. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Little, M. J. Khoury, L. Bradley, M. Clyne, M. Gwinn, B. Lin, M.-L. Lindegren, and P. Yoon The Human Genome Project Is Complete. How Do We Develop a Handle for the Pump? Am. J. Epidemiol., April 15, 2003; 157(8): 667 - 673. [Full Text] [PDF]
|
|
|
|
 |
|
 D. A Lawlor and A. R Ness Commentary: The rough world of nutritional epidemiology: Does dietary fibre prevent large bowel cancer? Int. J. Epidemiol., April 1, 2003; 32(2): 239 - 243. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Fung, F. B. Hu, C. Fuchs, E. Giovannucci, D. J. Hunter, M. J. Stampfer, G. A. Colditz, and W. C. Willett Major Dietary Patterns and the Risk of Colorectal Cancer in Women Arch Intern Med, February 10, 2003; 163(3): 309 - 314. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Boyle and M. E. Leon Epidemiology of colorectal cancer Br. Med. Bull., December 1, 2002; 64(1): 1 - 25. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Leslie and R J C Steele Management of colorectal cancer Postgrad. Med. J., August 1, 2002; 78(922): 473 - 478. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. I. Fenton, M. S. Wolff, M. W. Orth, and N. G. Hord Membrane-type matrix metalloproteinases mediate curcumin-induced cell migration in non-tumorigenic colon epithelial cells differing in Apc genotype Carcinogenesis, June 1, 2002; 23(6): 1065 - 1070. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Flood, E. M Velie, N. Chaterjee, A. F Subar, F. E Thompson, J. V Lacey Jr, C. Schairer, R. Troisi, and A. Schatzkin Fruit and vegetable intakes and the risk of colorectal cancer in the Breast Cancer Detection Demonstration Project follow-up cohort Am. J. Clinical Nutrition, May 1, 2002; 75(5): 936 - 943. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. S. Ritchie, K. Joshipura, H.-C. Hung, and C. W. Douglass NUTRITION AS A MEDIATOR IN THE RELATION BETWEEN ORAL AND SYSTEMIC DISEASE: ASSOCIATIONS BETWEEN SPECIFIC MEASURES OF ADULT ORAL HEALTH AND NUTRITION OUTCOMES Crit. Rev. Oral. Biol. Med., May 1, 2002; 13(3): 291 - 300. [Abstract] [Full Text]
|
|
|
|
 |
|
 L. Dreyer, J. F. Winther, and J. Olsen Avoidable deaths from cancer in the Nordic countries around the year 2000 Scand J Public Health, October 1, 2001; 29(4): 318 - 319. [PDF]
|
|
|
|
|
|
K. B Michels A renaissance for measurement error Int. J. Epidemiol., June 1, 2001; 30(3): 421 - 422. [Full Text] [PDF]
|
|
|
|
|
|
R. Nelson, V. Persky, and M. Turyk Diet and Cancer Prevention J Natl Cancer Inst, May 16, 2001; 93(10): 790 - 791. [Full Text] [PDF]
|
|
|
|
|
|
K. B. Michels, E. Giovannucci, D. Feskanich, and W. C. Willett Response J Natl Cancer Inst, May 16, 2001; 93(10): 791 - 791. [Full Text] [PDF]
|
|
|
|
|
|
A. Schatzkin and A. Flood Response J Natl Cancer Inst, May 16, 2001; 93(10): 791a - 792a. [Full Text] [PDF]
|
|
|
|
|
|
M. S. Sandhu, I. R. White, and K. McPherson Systematic Review of the Prospective Cohort Studies on Meat Consumption and Colorectal Cancer Risk: A Meta-Analytical Approach Cancer Epidemiol. Biomarkers Prev., May 1, 2001; 10(5): 439 - 446. [Abstract] [Full Text]
|
|
|
|
|
|
P. Terry, E. Giovannucci, K. B. Michels, L. Bergkvist, H. Hansen, L. Holmberg, and A. Wolk Fruit, Vegetables, Dietary Fiber, and Risk of Colorectal Cancer J Natl Cancer Inst, April 4, 2001; 93(7): 525 - 533. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. Slattery Does an Apple a Day Keep Breast Cancer Away? JAMA, February 14, 2001; 285(6): 799 - 801. [Full Text] [PDF]
|
|
|
|
|
|
A. Flood and A. Schatzkin Colorectal Cancer: Does It Matter if You Eat Your Fruits and Vegetables? J Natl Cancer Inst, November 1, 2000; 92(21): 1706 - 1707. [Full Text] [PDF]
|
|