© 2004 by Oxford University Press
© 2004 Oxford University Press
EDITORIAL |
Could Exposure Assessment Problems Give Us Wrong Answers to Nutrition and Cancer Questions?
Affiliations of authors: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD (AS); Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD (VK)
Correspondence to: Arthur Schatzkin, MD, DrPH, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., Ste. 320, Rm. 3040, Rockville, MD 20852-7232 (e-mail: schatzka@mail.nih.gov)
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Whether fruits and vegetables provide protection from cancer is of considerable public health importance—but it remains an open question. In this issue of the Journal, Hung et al. report findings from two cohort studies: fruit and vegetable intake is associated with a "modest" reduction in risk of noncommunicable ("chronic") disease (1). This reduction is confined to cardiovascular disease. The association for cancer is null.
Most evidence for a protective role of fruits and vegetables against cancer has comes from case–control studies. The authors rightly note the possibility of recall bias in such studies. Indeed, prospective cohort studies have tended to demonstrate weak or no associations between fruit and vegetable intake and malignant disease, including large-bowel cancer (2).
So the question arises: does total fruit and vegetable intake really confer little or no cancer protection? (In this editorial we
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