Consumption of fruits, vegetables and fruit juices and differentiated thyroid carcinoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study
Zamora-Ros, Raul; Béraud, Virginie; Franceschi, Silvia; Cayssials, Valerie; Tsilidis, Konstantinos K.; Boutron-Ruault, Marie Christine; Weiderpass, Elisabete; Overvad, Kim; Tjønneland, Anne; Eriksen, Anne K.; Bonnet, Fabrice; Affret, Aurélie; Katzke, Verena; Kühn, Tilman; Boeing, Heiner; Trichopoulou, Antonia; Valanou, Elisavet; Karakatsani, Anna; Masala, Giovanna; Grioni, Sara; Santucci de Magistris, Maria; Tumino, Rosario; Ricceri, Fulvio; Skeie, Guri; Parr, Christine L.; Merino, Susana; Salamanca-Fernández, Elena; Chirlaque, Maria-Dolores; Ardanaz, Eva; Amiano, Pilar; Almquist, Martin; Drake, Isabel; Hennings, Joakim; Sandström, Maria; Bueno-de-Mesquita, H. Bas; Peeters, Petra H.; Khaw, Kay-Thee; Wareham, Nicholas J.; Schmidt, Julie A.; Perez-Cornago, Aurora; Aune, Dagfinn; Riboli, Elio; Slimani, Nadia; Scalbert, Augustin; Romieu, Isabelle; Agudo, Antonio; Rinaldi, Sabina
(2018) International Journal of Cancer, volume 142, issue 3, pp. 449 - 459
(Article)
Abstract
Fruit and vegetable (F&V) intake is considered as probably protective against overall cancer risk, but results in previous studies are not consistent for thyroid cancer (TC). The purpose of this study is to examine the association between the consumption of fruits, vegetables, fruit juices and differentiated thyroid cancer risk within
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the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The EPIC study is a cohort including over half a million participants, recruited between 1991 and 2000. During a mean follow-up of 14 years, 748 incident first primary differentiated TC cases were identified. F&V and fruit juice intakes were assessed through validated country-specific dietary questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models adjusted for potential confounding factors. Comparing the highest versus lowest quartile of intake, differentiated TC risk was not associated with intakes of total F&V (HR: 0.89; 95% CI: 0.68–1.15; p-trend = 0.44), vegetables (HR: 0.89; 95% CI: 0.69–1.14; p-trend = 0.56), or fruit (HR: 1.00; 95% CI: 0.79–1.26; p-trend = 0.64). No significant association was observed with any individual type of vegetable or fruit. However, there was a positive borderline trend with fruit juice intake (HR: 1.23; 95% CI: 0.98–1.53; p-trend = 0.06). This study did not find any significant association between F&V intakes and differentiated TC risk; however a positive trend with fruit juice intake was observed, possibly related to its high sugar content.
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Keywords: EPIC, fruit juices, fruits, intake, thyroid cancer, vegetables, Oncology, Cancer Research
ISSN: 0020-7136
Publisher: Wiley-Liss Inc.
Note: Funding Information: Key words: thyroid cancer, fruits, vegetables, fruit juices, intake, EPIC Abbreviations: 24-HDR: 24-h dietary recall; BMI: body mass index; CI: confidence interval; EPIC: European Prospective Investigation into Cancer and Nutrition; F&V: fruits and vegetables; HR: hazard ratio; IARC: International Agency for Research on Cancer; NOS: not otherwise specified; TC: thyroid cancer Additional Supporting Information may be found in the online version of this article. †R.Z.-R. and V.B. equally contributed to this research. Conflict of Interest: The authors declare no conflict of interest. Grant sponsor: Institute of Health Carlos III, Spain; Grant number: CP15/00100; Grant sponsor: European Regional Development Fund (ERDF) “A way to build Europe”; Grant sponsor: European Commission (DG-SANCO) and the International Agency for Research on Cancer (The coordination of EPIC); Grant sponsor: Danish Cancer Society (Denmark; The national cohorts); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santéet de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF) (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Grant sponsor: Health Research Fund (FIS); Grant number: PI13/00061 (to Granada); PI13/01162 (to EPIC-Murcia); Grant sponsor: Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra; Grant sponsor: AGAUR-Generalitat de Catalunya; Grant number: exp. 2014 SGR 726; Grant sponsor: The Health Research Funds; Grant number: RD12/0036/0018 (Spain); Grant sponsor: Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and V€asterbotten (Sweden); Grant sponsor: Cancer Research UK; Grant number: 14136 (to EPIC-Norfolk), C570/A16491 and C8221/A19170 (to EPIC-Oxford); Grant sponsor: Medical Research Council; Grant number: 1000143 (to EPIC-Norfolk) and MR/M012190/1 (to EPIC-Oxford; United Kingdom); Grant sponsor: Institute of Health Carlos III (Spain) and the European Social Fund (ESF; R.Z.-R. would like to thank the “Miguel Servet” program); Grant number: CP15/00100 DOI: 10.1002/ijc.30880 History: Received 6 Apr 2017; Accepted 20 June 2017; Online 8 July 2017 Correspondence to: Raul Zamora-Ros, Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Av Gran Via 199-203, 08908 L’Hospitalet de Llobregat, Spain, Tel.: 134 932067401, Fax: 134 932607787, E-mail: rza-mora@iconcologia.net Funding Information: The authors thank Mr Bertrand Hémon and Miss Leila Luján-Barroso for their valuable help with the EPIC database. Publisher Copyright: © 2017 UICC
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