Fruit and vegetable consumption and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition.
Vrieling A., Verhage BAJ., van Duijnhoven FJB., Jenab M., Overvad K., Tjønneland A., Olsen A., Clavel-Chapelon F., Boutron-Ruault M-C., Kaaks R., Rohrmann S., Boeing H., Nöthlings U., Trichopoulou A., John T., Dimosthenes Z., Palli D., Sieri S., Mattiello A., Tumino R., Vineis P., van Gils CH., Peeters PHM., Engeset D., Lund E., Rodríguez Suárez L., Jakszyn P., Larrañaga N., Sánchez M-J., Chirlaque M-D., Ardanaz E., Manjer J., Lindkvist B., Hallmans G., Ye W., Bingham S., Khaw K-T., Roddam A., Key T., Boffetta P., Duell EJ., Michaud DS., Riboli E., Bueno-de-Mesquita HB.
Many case-control studies have suggested that higher consumption of fruit and vegetables is associated with a lower risk of pancreatic cancer, whereas cohort studies do not support such an association. We examined the associations of the consumption of fruits and vegetables and their main subgroups with pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is comprised of over 520,000 subjects recruited from 10 European countries. The present study included 555 exocrine pancreatic cancer cases after an average follow-up of 8.9 years. Estimates of risk were obtained by Cox proportional hazard models, stratified by age at recruitment, gender, and study center, and adjusted for total energy intake, weight, height, history of diabetes mellitus, and smoking status. Total consumption of fruit and vegetables, combined or separately, as well as subgroups of vegetables and fruits were unrelated to risk of pancreatic cancer. Hazard ratios (95% CI) for the highest versus the lowest quartile were 0.92 (0.68-1.25) for total fruit and vegetables combined, 0.99 (0.73-1.33) for total vegetables, and 1.02 (0.77-1.36) for total fruits. Stratification by gender or smoking status, restriction to microscopically verified cases, and exclusion of the first 2 years of follow-up did not materially change the results. These results from a large European prospective cohort suggest that higher consumption of fruit and vegetables is not associated with decreased risk of pancreatic cancer.