Open AccessRisk of lung cancer and consumption of vegetables and fruit in Japanese: A pooled analysis of cohort studies in Japan
Author(s) -
Wakai Kenji,
Sugawara Yumi,
Tsuji Ichiro,
Tamakoshi Akiko,
Shimazu Taichi,
Matsuo Keitaro,
Nagata Chisato,
Mizoue Tetsuya,
Tanaka Keitaro,
Inoue Manami,
Tsugane Shoichiro,
Sasazuki Shizuka
Publication year - 2015
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.12707
Subject(s) - hazard ratio , medicine , confidence interval , lung cancer , incidence (geometry) , cohort study , cohort , proportional hazards model , population , epidemiology , demography , lower risk , environmental health , physics , sociology , optics
International reviews have concluded that consumption of fruit and vegetables might decrease the risk of lung cancer. However, the relevant epidemiological evidence still remains insufficient in Japan. Therefore, we performed a pooled analysis of data from four population‐based cohort studies in Japan with >200 000 participants and >1700 lung cancer cases. We computed study‐specific hazard ratios by quintiles of vegetable and fruit consumption as assessed by food frequency questionnaires. Summary hazard ratios were estimated by pooling the study‐specific hazard ratios with a fixed‐effect model. In men, we found inverse associations between fruit consumption and the age‐adjusted and area‐adjusted risk of mortality or incidence of lung cancer. However, the associations were largely attenuated after adjustment for smoking and energy intake. The significant decrease in risk among men remained only for a moderate level of fruit consumption; the lowest summary hazard ratios were found in the third quintile of intake (mortality: 0.71, 95% confidence interval 0.60–0.84; incidence: 0.83, 95% confidence interval 0.70–0.98). This decrease in risk was mainly detected in ever smokers. Conversely, vegetable intake was positively correlated with the risk of incidence of lung cancer after adjustment for smoking and energy intake in men (trend P , 0.024); the summary hazard ratio for the highest quintile was 1.26 (95% confidence interval 1.05–1.50). However, a similar association was not detected for mortality from lung cancer. In conclusion, a moderate level of fruit consumption is associated with a decreased risk of lung cancer in men among the Japanese population.