| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 29) Koushik A. (2007) | Pooled Analysis of 11 Cohort Studies. | 688,904 subjects. | 7-20 years | 5,445 | Colon cancer risk | Apples, pears, applesauce |
INCLUSION CRITERIA:
- Publication of a diet and cancer association.
- Diagnosis of at least 50 incident colorectal cancer cases.
- Assessment of usual diet.
- Conduct of a validation study of the dietary assessment method or a closely related instrument.
INCLUDED STUDIES (Follow-up years/No. of colon cancer cases).
In the analysis, an extended follow-up period for most of the studies was included:
- The Cancer Prevention Study II Nutrition Cohort. (1992-1999/467 men, 349 women)
McCullough ML, Robertson AS, Chao A, Jacobs EJ, Stampfer MJ, Jacobs DR. A prospective study of whole grains, fruits, vegetables, and colon cancer risk. Cancer Causes Control. 2003 Dec;14(10):959-70. Abstract
- The Health Professionals Follow-up Study. (1986-2000/456 men)
Michels KB, Edward Giovannucci, Joshipura KJ, Rosner BA, Stampfer MJ, Fuchs CS. Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers. J Natl Cancer Inst. 2000 Nov 1;92(21):1740-52. Full text
- The Netherlands Cohort Study. (1986-1993/393 men, 353 women)
Voorrips LE, Goldbohm RA, van Poppel G, Sturmans F, Hermus RJ, van den Brandt PA. Vegetable and fruit consumption and risks of colon and rectal cancer in a prospective cohort study: The Netherlands Cohort Study on diet and cancer. Am J Epidemiol. 2000 Dec 1;152(11):1081-92. Full text
- The New York State Cohort. (1980-1987/335 men, 223 women)
Bandera EV, Freudenheim JL, Marshall JR, Zielezny M, Priore RL, Brasure J. Diet and alcohol consumption and lung cancer risk in the New York State Cohort (United States). Cancer Causes Control. 1997 Nov;8(6):828-40. Abstract
- The Breast Cancer Detection Demonstration Project Follow-up Study. (1987-1999/349 women)
Flood A, Velie EM, Chaterjee N, Subar AF, Thompson FE, Lacey JV Jr. Fruit and vegetable intakes and the risk of colorectal cancer in the Breast Cancer Detection Demonstration Project follow-up cohort. Am J Clin Nutr. 2002 May;75(5):936-43. Full text
- The Canadian National Breast Screening Study. (1980-2000/431 women)
Terry P, Jain M, Miller AB, Howe GR, Rohan TE. Dietary intake of folic acid and colorectal cancer risk in a cohort of women. Int J Cancer. 2002 Feb 20;97(6):864-7. Abstract
- The Iowa Women's Health Study. (1986-2001/799 women)
Steinmetz KA, Kushi LH, Bostick RM, Folsom AR, Potter JD. Vegetables, and fruit colon cancer in the Iowa Women's Health Study. Am J Epidemiol. 1994 Jan 1;139(1):1-15. Abstract
- The New York University Women's Health Study. (1985-1998/96 women)
Kato I, Akhmedkhanov A, Koenig K, Toniolo PG, Shore RE, Riboli E. Prospective study of diet and female colorectal cancer: the New York University Women's Health Study. Nutr Cancer. 1997;28(3):276-81. Abstract
- The Nurses' Health Study A + B. (A = 1980-1986/162 women. B = 1986-2000/429 women)
Michels KB, Edward Giovannucci, Joshipura KJ, Rosner BA, Stampfer MJ, Fuchs CS. Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers. J Natl Cancer Inst. 2000 Nov 1;92(21):1740-52. Full text
- The Swedish Mammography Cohort. (1987-2003/484 women)
Terry P, Giovannucci E, Michels KB, Bergkvist L, Hansen H, Holmberg L. Fruit, vegetables, dietary fiber, and risk of colorectal cancer. J Natl Cancer Inst. 2001 Apr 4;93(7):525-33. Full text
- The Women's Health Study. (1993-2003/163 women)
Lin J, Zhang SM, Cook NR, Rexrode KM, Liu S, Manson JE. Dietary intakes of fruit, vegetables, and fiber, and risk of colorectal cancer in a prospective cohort of women (United States). Cancer Causes Control. 2005 Apr;16(3):225-33. Abstract
RELATIVE RISK:
RR = 0.98 (0.88-1.10; P = 0.18) for the highest vs lowest quartile of consumption.
Amount specific data (servings):
0: RR = 1.
> 0 to < 1/wk: RR = 1.05 (0.94-1.17).
1/wk to < 0.5/day: RR = 0.98 (0.88-1.09).
≥ 0.5/day: RR = 0.98 (0.88-1.10).
One serving = 1 apple/pear or 1/2 cup applesauce.
| BMI; height; education; physical activity; family history of colorectal cancer; postmenopausal hormone use; oral contraceptive use; use of nonsteroidal anti-inflammatory drugs; multivitamin use; smoking habits (never/past/current + amount); red meat; total milk; alcohol; and total energy. Age in years and year of questionnaire return were included as stratification variables. |
| 25) Tsubono Y. (2005) | Cohort II from The JPHC Study. | 48,552 subjects 40-69 years (23,180 men and 25,372 women). | 6
(1993-99) | No data shown. | Colorectal cancer risk | Apples | No individual fruit showed significant relations with risk of colon or rectal cancer (no data shown). | sex, age, public health centre area, BMI, frequency of sports, smoking, alcohol consumption, vitamin supplement use, energy, cereals, meat, and fish by each cohort. |
| 23) Lin J. (2005) | The Women's Health Study. | 36,976 women aged > or = 45 years.
(USA) | 10 | 222? | Colorectal cancer risk | Apples, or
Apple juice | Intakes of individual fruit items were found not appreciably to be associated with colorectal cancer risk (data not shown). | age, randomized treatment assignment, BMI, family history of colorectal cancer, history of colon polyps, physical activity, smoking status, baseline aspirin use, red meat intake, alcohol consumption, total energy intake, menopausal status, baseline post-menopausal HT use, folate intake and multivitamin use. Glycemic load in the multivariate model did not change the overall results. |
| 9) Voorrips LE. (2000) | The Netherlands Cohort Study. | 62,573 women and 58,279 men aged 55-69.
(The Netherlands) | 6.3
(1986-1992) | 611? colon (331 men, 280 women), and 334? rectal (215 men, 119 women) | Colorectal cancer risk | Apples/pears |
Stratified by cancer site
| Colon cancer | Rectal cancer |
Men: RR = 1.01
Women: RR = 0.97 | Men: RR = 1.01
Women: RR = 0.97 |
RRs are for an increment of 25 g/day.Age, family history of colorectal cancer, alcohol, and items in the cooked vegetable group, raw vegetable group, and fruit group. Total energy intake, smoking, physical activity, and BMI were evaluated as potential confounders. |
| 6) Lin J. (2006) | The Nurses's Health Study + The Health Professionals Follow Up Study. | 71,976 women and 35,425 men. (USA) | 10
(1990-2000) | 878 of which 701 colon (408 women, 293 men), and 177 rectal (90 women, 87 men) | Colorectal cancer risk | Apples (including apple juice or cider and fresh apple) |
| Women: | Men: |
RR = 0.64 (0.35-1.17; P = 0.74) for the highest vs lowest quintile of consumption.
Amount specific data (servings):
0-2/wk: RR = 1.
3-4/wk: RR = 1.07 (0.86-1.34).
5-6/wk: RR = 1.23 (0.91-1.66).
1/day: RR = 0.78 (0.47-1.28).
≥ 2/day: RR = 0.64 (0.35-1.17).
|
RR = 0.82 (0.51-1.30; P = 0.06) for the highest vs lowest quintile of consumption.
Amount specific data (servings):
0-2/wk: RR = 1.
3-4/wk: RR = 1.01 (0.77-1.31).
5-6/wk: RR = 1.07 (0.76-1.50).
1/day: RR = 0.46 (0.25-0.87).
≥ 2/day: RR = 0.82 (0.51-1.30).
|
Age, BMI, family history of colorectal cancer, history of colorectal polyps, prior sigmoidoscopy screening, physical activity, smoking status, red meat intake, alcohol consumption, total energy intake, total calcium intake, total folate intake, total fiber intake, aspirin use, and multivitamin use. Among women, multivariate models also included adjustment for postmenopausal hormone replacement therapy. |
| 6) Michels KB. (2000) | The Nurses' Health Study
&
The Health Professionals' Follow-up Study. | 88,764 women aged 34-59 and 47,325 men aged 40-75.
(USA) | Women: 16
(1980-1996).
Men: 10
(1986-1996) | 1,181?
(937 colon cancer [368 men, 569 women], 244 rectal cancer [89 men, 155 women]) | Colorectal cancer risk | Apples, applesauce, or pears | Intake of individual fruits that constitute the composite items was not appreciably associated with colon or rectal cancer risk in women or men (No data shown). | age, family history of colorectal cancer, sigmoidoscopy, height, body mass index, pack-years of smoking, alcohol intake, physical activity, (women: menopausal status, postmenopausal hormone use,) aspirin use, vitamin supplement intake (ever use of multivitamins or vitamins A, C, or E), total caloric intake, and red meat consumption. |
| 6) Giovannucci E. (1994) | The Health Professionals Follow-up Study. | 47,949 men aged 40-75.
(USA) | 1986-1992 | 205? | Colon cancer risk | Apples, or pears | Of all fruits items examined individually, none were statistically significantly related to the risk of colon cancer (no data shown). | Age, energy. |
| 6) Willet WC (1990) | The Nurses' Health Study. | 88,751 women aged 34-59. | 6
(1980-86) | 150? | Colon cancer incidence
(only invasive adenocarcinoma) | Apples or pears | An inverse trend (no data shown; P = 0.16). | Age. |
| |