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Consumption of vegetables and fruits and risk of subtypes of head-neck cancer in the Netherlands Cohort Study

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Author: Maasland, D.H.E. · Brandt, P.A. van den · Kremer, B. · Goldbohm, R.A. · Schouten, L.J.
Source:International Journal of Cancer, 5, 136, E396-E409
Identifier: 521634
doi: doi:10.1002/ijc.29219
Keywords: Health · Cohort studies · Etiology · Fruits · Head-neck cancer · Vegetables · Adult · Aged · Alcohol consumption · Cancer risk · Cohort analysis · Dietary intake · Female · Head and neck cancer · Human · Hypopharynx cancer · Larynx cancer · Major clinical study · Male · Mouth cancer · Netherlands · Oropharynx cancer · Prospective study · Risk assessment · Risk reduction · Smoking · Healthy for Life · Healthy Living · Life · LS - Life Style · ELSS - Earth, Life and Social Sciences


There is limited prospective data on the relationship between consumption of vegetables and fruits and the risk of head-neck cancer (HNC) subtypes [i.e., oral cavity cancer (OCC), oro-/hypopharyngeal cancer (OHPC) and laryngeal cancer (LC)]. Therefore, we investigated these associations within the Netherlands Cohort Study, in which 120,852 participants completed a 150-item food frequency questionnaire at baseline in 1986. After 20.3 years of follow-up, 415 cases of HNC (131 OCC, 88 OHPC, three oral cavity/pharynx unspecified or overlapping and 193 LC) and 3,898 subcohort members were available for case-cohort analysis using Cox proportional hazards models. Total vegetable and fruit consumption was inversely associated with risk of HNC overall [multivariable-adjusted rate ratios for highest vs. lowest quartile: 0.61, 95% confidence interval (CI) 0.44-0.85, p trend 0.002] and all HNC subtypes, with the strongest associations for OCC. Total vegetable intake and total fruit intake were also associated with a decreased risk of HNC overall and HNC subtypes. No significant interaction was found between vegetable and fruit intake and alcohol consumption or cigarette smoking. In conclusion, in this large-scale cohort study, consumption of vegetables and fruits was associated with a decreased risk of HNC overall and all subtypes. Consumption of vegetables and fruits (or of specific groups of them) may protect against HNC and its subtypes.