© 2000 by Oxford University Press
Journal of the National Cancer Institute, Vol. 92, No. 21, 1740-1752,
November 1, 2000
© 2000 Oxford University Press
Prospective Study of Fruit and Vegetable Consumption and Incidence of Colon and Rectal Cancers
Affiliations of authors: K. B. Michels, M. J. Stampfer, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, and Department of Epidemiology, Harvard School of Public Health, Boston; E. Giovannucci, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Department of Nutrition, Harvard School of Public Health, Boston; K. J. Joshipura, Department of Epidemiology, Harvard School of Public Health, and Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston; B. A. Rosner, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Department of Biostatistics, Harvard School of Public Health; C. S. Fuchs, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Department of Adult Oncology, Dana-Farber Cancer Institute, Boston; G. A. Colditz, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Department of Epidemiology and Harvard Center for Cancer Prevention, Harvard School of Public Health; F. E. Speizer, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School; W. C. Willett, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Departments of Epidemiology and Nutrition, Harvard School of Public Health.
Correspondence to: Karin B. Michels, Sc.D., Channing Laboratory, 181 Longwood Ave., Boston, MA 02115 (e-mail: kmichels{at}rics.bwh.harvard.edu).
Background: Frequent consumption of fruit and vegetables has been associated with a reduced risk of colorectal cancer in many observational studies. Methods: We prospectively investigated the association between fruit and vegetable consumption and the incidence of colon and rectal cancers in two large cohorts: the Nurses' Health Study (88 764 women) and the Health Professionals' Follow-up Study (47 325 men). Diet was assessed and cumulatively updated in 1980, 1984, 1986, and 1990 among women and in 1986 and 1990 among men. The incidence of cancer of the colon and rectum was ascertained up to June or January of 1996, respectively. Relative risk (RR) estimates were calculated with the use of pooled logistic regression models accounting for various potential confounders. All statistical tests were two-sided. Results: With a follow-up including 1 743 645 person-years and 937 cases of colon cancer, we found little association of colon cancer incidence with fruit and vegetable consumption. For women and men combined, a difference in fruit and vegetable consumption of one additional serving per day was associated with a covariate-adjusted RR of 1.02 (95% confidence interval [CI] = 0.98–1.05). A difference in vegetable consumption of one additional serving per day was associated with an RR of 1.03 (95% CI = 0.97–1.09). Similar results were obtained for women and men considered separately. A difference in fruit consumption of one additional serving per day was associated with a covariate-adjusted RR for colon cancer of 0.96 (95% CI = 0.89–1.03) among women and 1.08 (95% CI = 1.00–1.16) among men. For rectal cancer (total, 244 cases), a difference in fruit and vegetable consumption of one additional serving per day was associated with an RR of 1.02 (95% CI = 0.95–1.09) in men and women combined. None of these associations was modified by vitamin supplement use or smoking habits. Conclusions: Although fruits and vegetables may confer protection against some chronic diseases, their frequent consumption does not appear to confer protection from colon or rectal cancer.
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