Title: Vegetable intake and the risk of bladder cancer in the BLadder Cancer Epidemiology and Nutritional Determinants (BLEND) international study

Abstract

Although a potential inverse association between vegetable intake and bladder cancer risk has been reported, epidemiological evidence is inconsistent. This research aimed to elucidate the association between vegetable intake and bladder cancer risk by conducting a pooled analysis of data from prospective cohort studies. Vegetable intake in relation to bladder cancer risk was examined by pooling individual-level data from 13 cohort studies, comprising 3203 cases among a total of 555,685 participants. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were estimated using Cox proportional hazards regression models stratified by cohort for intakes of total vegetable, vegetable subtypes (i.e. non-starchy, starchy, green leafy and cruciferous vegetables) and individual vegetable types. In addition, a diet diversity score was used to assess the association of the varied types of vegetable intake on bladder cancer risk. The association between vegetable intake and bladder cancer risk differed by sex (P-interaction = 0.011) and smoking status (P-interaction = 0.038); therefore, analyses were stratified by sex and smoking status. With adjustment of age, sex, smoking, energy intake, ethnicity and other potential dietary factors, we found that higher intake of total and non-starchy vegetables were inversely associated with the risk of bladder cancer among womenmore » (comparing the highest with lowest intake tertile: HR = 0.79, 95% CI = 0.64–0.98,P = 0.037 for trend, HR per 1 SD increment = 0.89, 95% CI = 0.81–0.99; HR = 0.78, 95% CI = 0.63–0.97,P = 0.034 for trend, HR per 1 SD increment = 0.88, 95% CI = 0.79–0.98, respectively). However, no evidence of association was observed among men, and the intake of vegetable was not found to be associated with bladder cancer when stratified by smoking status. Moreover, we found no evidence of association for diet diversity with bladder cancer risk. Higher intakes of total and non-starchy vegetable are associated with reduced risk of bladder cancer for women. Further studies are needed to clarify whether these results reflect causal processes and potential underlying mechanisms.« less

Authors:

Yu, Evan Yi-Wen ^[1]; Wesselius, Anke  ^[2];

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Mehrkanoon, Siamak ^[3]; Goosens, Mieke ^[4]; Brinkman, Maree ^[5]; van den Brandt, Piet ^[6]; Grant, Eric J. ^[7]; White, Emily ^[8]; Weiderpass, Elisabete ^[9]; Le Calvez-Kelm, Florence ^[9]; Gunter, Marc J. ^[9]; Huybrechts, Inge ^[9]; Riboli, Elio ^[10]; Tjonneland, Anne ^[11]; Masala, Giovanna ^[12]; Giles, Graham G. ^[13]; Milne, Roger L. ^[13]; Zeegers, Maurice P. ^[14]

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1. Maastricht Univ., Maastricht (Netherlands). School of Nutrition and Translational Research in Metabolism. Dept. of Complex Genetics and Epidemiology; Maastricht Univ., Maastricht (Netherlands). CAPHRI School for Public Health and Primary Care
2. Maastricht Univ., Maastricht (Netherlands). School of Nutrition and Translational Research in Metabolism. Dept. of Complex Genetics and Epidemiology
3. Maastricht Univ., Maastricht (Netherlands). Dept. of Data Science and Knowledge Engineering
4. Katholieke Univ. Leuven, Heverlee (Belgium). Dept. of General Practice
5. Maastricht Univ., Maastricht (Netherlands). School of Nutrition and Translational Research in Metabolism. Dept. of Complex Genetics and Epidemiology; Nutrition Biomed Research Inst., Melbourne (Australia). Dept. of Clinical Studies and Nutritional Epidemiology; Cancer Council Victoria, Melbourne, VIC (Australia). Cancer Epidemiology Division
6. Maastricht Univ., Maastricht (Netherlands). Medical Centre. Schools for Oncology and Developmental Biology and Public Health and Primary Care. Dept. of Epidemiology
7. Radiation Effects Research Foundation, Hiroshima (Japan). Dept. of Epidemiology
8. Fred Hutchinson Cancer Research Center, Seattle, WA (United States)
9. World Health Organization, Lyon (France). International Agency for Research on Cancer
10. Imperial College, London (United Kingdom). School of Public Health. Dept. of Epidemiology and Biostatistics
11. Danish Cancer Society Research Center, Copenhagen (Denmark); Univ. of Copenhagen (Denmark). Dept. of Public Health
12. Inst. for Cancer Research, Prevention and Clinical Network ISPRO, Florence (Italy). Cancer Risk Factors and Lifestyle Epidemiology Unit. Molecular and Lifestyle Epidemiology Branch
13. Nutrition Biomed Research Inst., Melbourne (Australia). Dept. of Clinical Studies and Nutritional Epidemiology; Cancer Council Victoria, Melbourne, VIC (Australia). Cancer Epidemiology Division; Univ. of Melbourne (Australia). Melbourne School of Population and Global Health. Centre for Epidemiology and Biostatistics; Monash Univ., Clayton, VIC (Australia)
14. Maastricht Univ., Maastricht (Netherlands). School of Nutrition and Translational Research in Metabolism. Dept. of Complex Genetics and Epidemiology; Maastricht Univ., Maastricht (Netherlands). CAPHRI School for Public Health and Primary Care; Univ. of Birmingham (United Kingdom). School of Cancer Sciences

Publication Date:

Tue Mar 09 00:00:00 EST 2021

Research Org.:

National Academy of Sciences, Washington, DC (United States)

Sponsoring Org.:

USDOE Office of Environment, Health, Safety and Security (AU); World Cancer Research Fund International; European Commission (EC); National Institutes of Health (NIH); Australian National Health and Medical Research Council

OSTI Identifier:

1850257

Grant/Contract Number:  

HS0000031; WCRF 2012/590; P7-PEOPLE- 618308; R01CA74846; 209057; 396414; 1074383

Resource Type:

Accepted Manuscript

Journal Name:

BMC Medicine

Additional Journal Information:

Journal Volume: 19; Journal Issue: 1; Journal ID: ISSN 1741-7015

Publisher:

BioMed Central

Country of Publication:

United States

Language:

English

Subject:

59 BASIC BIOLOGICAL SCIENCES; General & Internal Medicine; Bladder cancer; Vegetable; Dietary diversity analysis; Cohort study