Fruit and vegetable consumption and lymphoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).
Rohrmann S., Becker N., Linseisen J., Nieters A., Rüdiger T., Raaschou-Nielsen O., Tjønneland A., Johnsen HE., Overvad K., Kaaks R., Bergmann MM., Boeing H., Benetou V., Psaltopoulou T., Trichopoulou A., Masala G., Mattiello A., Krogh V., Tumino R., van Gils CH., Peeters PHM., Bueno-de-Mesquita HB., Ros MM., Lund E., Ardanaz E., Chirlaque M-D., Jakszyn P., Larrañaga N., Losada A., Martínez-García C., Agren A., Hallmans G., Berglund G., Manjer J., Allen NE., Key TJ., Bingham S., Khaw KT., Slimani N., Ferrari P., Boffetta P., Norat T., Vineis P., Riboli E.
INTRODUCTION: Lymphomas are a heterogeneous group of malignant diseases of cells of the immune system. The best-established risk factors are related to dys-regulation of immune function, and evidence suggests that factors such as dietary or lifestyle habits may be involved in the etiology. MATERIAL AND METHODS: In the European Prospective Investigation into Cancer and Nutrition (EPIC), 849 lymphoma cases were identified in a median follow-up period of 6.4 years. Fruit and vegetable consumption was estimated from validated dietary questionnaires. Cox proportional hazard models were used to examine the association between fruit and vegetable intake with the risk of lymphomas overall and subentities. RESULTS: There was no overall association between total fruit and vegetable consumption and risk of lymphoma [hazard ratio (HR)=0.95, 95% confidence interval (CI) 0.78-1.15 comparing highest with lowest quartile]. However, the risk of diffuse large B-cell lymphomas (DLBCL) tended to be lower in participants with a high intake of total vegetables (HR=0.49, 95% CI 0.23-1.02). CONCLUSION: In this large prospective study, an inverse associations between fruit and vegetable consumption and risk of lymphomas overall could not be confirmed. Associations with lymphoma subentities such as DLBCL warrant further investigation.