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Consumption of fruits, vegetables and fruit juices and differentiated thyroid carcinoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain. International Agency for Research on Cancer (IARC), Lyon, France. Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. School of Public Health, Imperial College London, London, United Kingdom. CESP, Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France. Institut Gustave Roussy, Villejuif, F-94805, France. Department of Community Medicine, Faculty of Health Sciences, UiT, The Artic University of Tromsø, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. Danish Cancer Society Research Center, Copenhagen, Denmark. CHU Rennes, Rennes 1 University, Rennes, France. Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. Hellenic Health Foundation, Athens, Greece. WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. 2nd Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" University Hospital, Haidari, Greece. Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy. Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. Cancer Registry and Histopathology Unit, "Civic M.P. Arezzo" Hospital, ASP Ragusa, Italy. Department of Clinical and Biological Sciences, University of Turin, Turin, Italy. Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, (TO), Italy. Domain of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway. Public Health Directorate, Asturias, Spain. Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.Granada. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. Navarra Public Health Institute, Pamplona, Spain. Navarra Institute for Health Research (IdiSNA) Pamplona, Pamplona, Spain. Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Bilbao, Spain. Department of Surgery, University Hospital Lund, Lund, Sweden. Malmö Diet and Cancer Study, University Hospital Malmö, Malmö, Sweden. Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden. Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden. Department for Radiation Sciences, Umeå University, Umeå, Sweden. Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. University of Cambridge School of Clinical Medicine, MRC Epidemiology Unit, Cambridge, United Kingdom. Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom. Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. Bjørknes University College, Oslo, Norway.

International journal of cancer. 2018;(3):449-459
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Abstract

Fruit and vegetable (F&V) intake is considered as probably protective against overall cancer risk, but results in previous studies are not consistent for thyroid cancer (TC). The purpose of this study is to examine the association between the consumption of fruits, vegetables, fruit juices and differentiated thyroid cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The EPIC study is a cohort including over half a million participants, recruited between 1991 and 2000. During a mean follow-up of 14 years, 748 incident first primary differentiated TC cases were identified. F&V and fruit juice intakes were assessed through validated country-specific dietary questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models adjusted for potential confounding factors. Comparing the highest versus lowest quartile of intake, differentiated TC risk was not associated with intakes of total F&V (HR: 0.89; 95% CI: 0.68-1.15; p-trend = 0.44), vegetables (HR: 0.89; 95% CI: 0.69-1.14; p-trend = 0.56), or fruit (HR: 1.00; 95% CI: 0.79-1.26; p-trend = 0.64). No significant association was observed with any individual type of vegetable or fruit. However, there was a positive borderline trend with fruit juice intake (HR: 1.23; 95% CI: 0.98-1.53; p-trend = 0.06). This study did not find any significant association between F&V intakes and differentiated TC risk; however a positive trend with fruit juice intake was observed, possibly related to its high sugar content.

Methodological quality

Publication Type : Multicenter Study

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