Vegetables and proximal colon cancer.
Total vegetables and proximal colon cancer risk.
Data about the relation between total vegetables and proximal colon cancer risk was provided by a pooled analysis of 14 cohorts, and two additional
cohorts, which were both of very large size. No associations were found.
The average RR = 1.06 (excluding incomplete data from Park Y [27]).
Inclusion of intermediate levels of consumption:
Among men, a significant protective effect was found in the 3rd quintile of consumption (median intake 270 g/day) in one cohort of very large size (Park Y). No
other associations were found. Clearly, no consistent level of consumption was found for any effect in both sexes:
Conclusion: No associations were found. No evidence was found for an association between total vegetables and proximal cancer risk.
| Author | Cohort name | Cases | Relative Risk (RR) |
|---|---|---|---|
| 29) Koushik A (2007) | Pooled analysis of 14 cohorts | 912 men, and 2,066 women | Men: RR = 1.36 (0.85-2.18; P = 0.78). Women: RR = 1.00 (0.81-1.22; P = 0.67). |
| 27) Park Y (2007) | The NIH-AARP Diet and Health Study | Not defined | Men: RR = 0.90 (0.72-1.14; P = 0.75). Women: RR = 1.06 (0.78-1.45; P = 0.87). |
| 18) van Duijnhoven FJ (2009) | The EPIC Study | 783 | HR = 0.86 (0.65-1.14; P = 0.53). |
| Total number of cases: 3,761 + X | Average RR = 1.06 |
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 29) Koushik A. (2007) | Pooled Analysis of 14 Cohort Studies. | 756,217 subjects (242,362 men and 513,855 women) | 6-20 years | 2978 (2066 women, 912 men) | Proximal colon cancer risk (tumors from the cecum to the splenic flexure) | Total vegetables (Vegetables and vegetable juices. Excluding potatoes and mature beans) |
INCLUSION CRITERIA:
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:
RELATIVE RISK:
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. |
27) Park Y. (2007) | The NIH-AARP Diet And Health Study. | 488,043 (291,094 men and 196,949 women) aged 50-71. | (USA) 4,3 | (1996-2000) No data shown. | (2,972 for total colorectal cancer risk ([2,048 men and 924 women]) Proximal colon cancer risk | Vegetables (Not defined. Excluding potatoes except sweet potatoes) |
|
One serving = 1 cup of leafy vegetables, 1/2 cup of other vegetables, or 6 ounces of juice (1 cup = 237 mL, 1 ounce = 29.6 mL). education, physical activity, smoking (smoking/past/current. And < or = 20 vs > 20 cigarettes/day), alcohol, red meat, dietary calcium, total energy. |
Additional adjustment for race; BMI; family history of colorectal cancer; colorectal cancer screening; use of multivitamins, NSAID's, and menopausal hormone therapy in women; and vitamin D intake showed similar results. Mutual adjustment for intakes of fruits and vegetables did not change the results. Adjustment for dietary fiber did not change the results. 23) Lin J. (2005) | The Women's Health Study. | 36,976 women aged > or = 45 years. | (USA) 10 | 91 | Proximal colon cancer risk | Vegetables (beans, beets, broccoli, Brussels sprouts, cabbage, cooked carrots, raw carrots, cauliflower, celery, red chili sauce, corn, eggplant, green pepper, iceberg lettuce, kale, mixed vegetables, cooked onions, raw onions, orange squash, peas, romaine lettuce, cooked spinach, raw spinach, string beans, soybeans, tofu, tomatoes, tomato juice, tomato sauce, yams/sweet potatoes) |
No association with proximal colon cancer risk (no data 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. |
18) van Duijnhoven FJ (2009) | The EPIC Study | 452,755 subjects (131,985 men and 320,770 women) from 10 European countries. | 8.7-8.8 | (1992-2000 to 2006) 783 | Proximal colon cancer incidence | (including the cecum, appendix, ascending colon, hepatic flexure, transverse colon, and splenic flexure) All vegetables (leafy vegetables, fruiting vegetables, root vegetables, cabbages, onions and garlic, mushrooms, grain and pod vegetables [e.g. peas], stalk vegetables and sprouts, mixed salads/mixed vegetables, and unclassified vegetables. | excluding legumes or potatoes and other tubers)
HR = 0.86 (0.65-1.14; P = 0.53) for the highest vs lowest quintile of consumption. | Effect modification: Tertiles of red and processed meat or alcohol did not modify the association between vegetable consumption and the risk of cancer (no data shown). BMI modified the association: an inverse association was most apparent in the highest tertile of BMI (no data shown). Stratified by age at entry, sex, and center. Adjusted for energy from fat, energy from nonfat, weight, height, physical activity, smoking status, alcohol consumption, red and processed meat consumption, fish consumption, dietary fiber from cereal sources, and consumption of fruit. |
15) Terry P (2001) | The Swedish Mammography Screening Cohort. | 61,463 women aged 40-74. | 9.6 | (1987-90 to 1998) 118 | Proximal colon cancer risk | Vegetables (such as cabbage, tomatoes, lettuce, spinach, potatoes, and carrots and beets) |
RR = 0.72 (0.44-1.20; P = 0.19) for the highest vs lowest quartile of consumption. | Amount specific data (servings/day): < 1.0: RR = 1. 1.0-1.5: RR = 0.71 (0.43-1.17). 1.5-2.0: RR = 0.73 (0.44-1.20). > 2.0: RR = 0.72 (0.44-1.20). Age, consumption of red meat and dairy products, and total calories. |
9) Voorrips LE. (2000) | The Netherlands Cohort Study. | 62,573 women and 58,279 men aged 55-69. | (The Netherlands) 6.3 | (1986-1992) 148 men, 138 women | Proximal colon cancer risk | Total vegetables (Brussels sprouts, cauliflower, cabbage, spinach, cooked endive, beetroot, string beans, broad beans, kale, cooked carrots, sweet peppers, sauerkraut, rhubarb, mushrooms, gherkins, raw endive, raw carrots, lettuce, tomatoes) |
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Age, family history of colorectal cancer, and alcohol. Total energy intake, smoking, physical activity, and BMI were evaluated as potential confounders. |
8) Steinmetz KA. (1994) | The Iowa Women's Health Study. | 35,216 women aged 55-69. | (USA) 5 | (1986-1990) 86 | Proximal colon cancer risk | Vegetables (alfalfa sprouts, artichokes, asparagus, avocado, bean sprouts, beets, broccoli, Brussels sprouts, cabbage/coleslaw, carrots, cauliflower, celery, chicory, corn, daikon radish, eggplant/zucchini/other summer squash, endive, escarole, garlic, green/chili peppers, iceberg/head lettuce, Jerusalem artichokes, kale/mustard/chard greens, kohlrabi, leeks, mixed vegetables, mushrooms, okra, oriental vegetables, parsley, parsnips, peapods, peas/lima beans, potatoes, radishes, rhubarb, romaine/leaf lettuce, rutabagas, scallions, spinach, string beans, tomatoes, tomato sauce, turnips, water chestnuts, yams, and yellow squash) |
RR = 0.90 (0.44-1.82) for the highest vs lowest quartile of consumption. | Amount specific data (servings/week): < 15.1: RR = 1. 15.1-21.5: RR = 1.22 (0.68-2.19). 21.6-30.4: RR = 1.33 (0.73-2.42). > 30.4: RR = 0.90 (0.44-1.82). Age, energy. The effect of adjustment of the vegetable and fruit associations for the following factors was negligible: BMI, parity, age at first live birth, physical activity, smoking, education, history of polyps or colitis, and alcohol intake. |
7) McCullough ML (2003) | The Cancer Prevention Study II Nutrition Cohort. | 62,609 men and 70,554 women aged 50-74. (The Nutrition Cohort is a subgroup of the approx. 1.2 million participants in CPS II) | 1992-93 to 1997 | 134? men, 126? women | Proximal colon cancer risk (cecum to splenic flexure) | Vegetables (defined as: beans, such as baked beans, limas, pintos, kidney, or in chili. Tomatoes, tomato juice. Broccoli. Spinach. Mustard greens, turnip greens, colards. Coleslaw, cabbage, sauerkraut. Carrots, or mixed vegetables containing carrots. Green salad. Sweet potatoes, yams. Any other vegetable, including green beans, corn, peas. Spaghetti, lasagna and other pasta with tomato sauce. Vegetable soup) |
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age, exercise, METs, aspirin, smoking, family history of colorectal cancer, BMI, education, energy, multivitamin use, total calcium and red meat intake. Alcohol intake was not included because it did not influence the effect estimates when entered in the multivariate models. |
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