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Fruits and Vegetables Intake and Gastric Cancer Risk: A Pooled Analysis Within the Stomach Cancer Pooling Project Publisher Pubmed



Ferro A1 ; Costa AR1 ; Morais S1, 2 ; Bertuccio P3, 4 ; Rota M3, 5 ; Pelucchi C3 ; Hu J6 ; Johnson KC7 ; Zhang ZF8 ; Palli D9 ; Ferraroni M3 ; Yu GP10 ; Bonzi R3 ; Peleteiro B1, 2 Show All Authors
Authors
  1. Ferro A1
  2. Costa AR1
  3. Morais S1, 2
  4. Bertuccio P3, 4
  5. Rota M3, 5
  6. Pelucchi C3
  7. Hu J6
  8. Johnson KC7
  9. Zhang ZF8
  10. Palli D9
  11. Ferraroni M3
  12. Yu GP10
  13. Bonzi R3
  14. Peleteiro B1, 2
  15. Lopezcarrillo L11
  16. Tsugane S12
  17. Hamada GS13
  18. Hidaka A12
  19. Malekzadeh R14
  20. Zaridze D15
  21. Maximovich D15
  22. Vioque J16, 17
  23. Navarretemunoz EM16, 17
  24. Alguacil J16, 18
  25. Castanovinyals G16, 19, 20, 21
  26. Wolk A22
  27. Hakansson N22
  28. Hernandezramirez RU23
  29. Pakseresht M14, 24, 25
  30. Ward MH26
  31. Pourfarzi F14, 27
  32. Mu L28
  33. Lopezcervantes M29
  34. Persiani R30, 31
  35. Kurtz RC32
  36. Lagiou A33
  37. Lagiou P34, 35
  38. Boffetta P36, 37
  39. Boccia S38, 39
  40. Negri E4
  41. Camargo MC26
  42. Curado MP40
  43. La Vecchia C3
  44. Lunet N1, 2
Show Affiliations
Authors Affiliations
  1. 1. EPIUnit – Instituto de Saude Publica, Universidade do Porto, Porto, Portugal
  2. 2. Departamento de Ciencias da Saude Publica e Forenses e Educacao Medica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
  3. 3. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
  4. 4. Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
  5. 5. Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
  6. 6. Harbin Medical University, Harbin, China
  7. 7. School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
  8. 8. Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson, Comprehensive Cancer Center, Los Angeles, CA, United States
  9. 9. Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
  10. 10. Medical Informatics Center, Peking University, Peking, China
  11. 11. Mexico National Institute of Public Health, Morelos, Mexico
  12. 12. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
  13. 13. Nikkei Disease Prevention Center, Sao Paulo, Brazil
  14. 14. Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  15. 15. Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russian Federation
  16. 16. Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
  17. 17. Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
  18. 18. Centro de Investigacion en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
  19. 19. ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
  20. 20. IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
  21. 21. Universitat Pompeu Fabra (UPF), Barcelona, Spain
  22. 22. Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  23. 23. Department of Biostatistics, Yale School of Public Health, Yale School of Medicine, New Haven, CT, United States
  24. 24. Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada
  25. 25. Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
  26. 26. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
  27. 27. Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
  28. 28. Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
  29. 29. Facultad de Medicina, UNAM, Coyoacan, Mexico
  30. 30. Dipartimento Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
  31. 31. Dipartimento di Chirurgia, Universita Cattolica del Sacro Cuore, Roma, Italy
  32. 32. Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, United States
  33. 33. Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
  34. 34. Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  35. 35. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
  36. 36. The Tisch Cancer Institute, Department of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  37. 37. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
  38. 38. Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanita Pubblica, Universita Cattolica del Sacro Cuore, Roma, Italy
  39. 39. Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
  40. 40. Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, Sao Paulo, Brazil

Source: International Journal of Cancer Published:2020


Abstract

A low intake of fruits and vegetables is a risk factor for gastric cancer, although there is uncertainty regarding the magnitude of the associations. In our study, the relationship between fruits and vegetables intake and gastric cancer was assessed, complementing a previous work on the association betweenconsumption of citrus fruits and gastric cancer. Data from 25 studies (8456 cases and 21 133 controls) with information on fruits and/or vegetables intake were used. A two-stage approach based on random-effects models was used to pool study-specific adjusted (sex, age and the main known risk factors for gastric cancer) odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Exposure-response relations, including linear and nonlinear associations, were modeled using one- and two-order fractional polynomials. Gastric cancer risk was lower for a higher intake of fruits (OR: 0.76, 95% CI: 0.64-0.90), noncitrus fruits (OR: 0.86, 95% CI: 0.73-1.02), vegetables (OR: 0.68, 95% CI: 0.56-0.84), and fruits and vegetables (OR: 0.61, 95% CI: 0.49-0.75); results were consistent across sociodemographic and lifestyles categories, as well as study characteristics. Exposure-response analyses showed an increasingly protective effect of portions/day of fruits (OR: 0.64, 95% CI: 0.57-0.73 for six portions), noncitrus fruits (OR: 0.71, 95% CI: 0.61-0.83 for six portions) and vegetables (OR: 0.51, 95% CI: 0.43-0.60 for 10 portions). A protective effect of all fruits, noncitrus fruits and vegetables was confirmed, supporting further dietary recommendations to decrease the burden of gastric cancer. © 2020 UICC
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