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Fruit and vegetable intake and prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

  • Aurora Perez-Cornago
  • Ruth C Travis
  • Paul N. Appleby
  • Konstantinos K Tsilidis
  • Anne Tjønneland
  • Anja Olsen
  • Kim Overvad
  • Verena Katzke
  • Tilman Kühn
  • Antonia Trichopoulou
  • Eleni Peppa
  • Maria Kritikou
  • Sabina Sieri
  • Domenico Palli
  • Carlotta Sacerdote
  • Rosario Tumino
  • Bas H. Bueno-De-Mesquita
  • Antonio Agudo
  • Nerea Larrañaga
  • Elena Molina-Portillo
  • Eva Ardanaz
  • Maria-Dolores Chirlaque
  • Cristina Lasheras
  • Pär Stattin
  • Maria Wennberg
  • Isabel Drake
  • Johan Malm
  • Julie A. Schmidt
  • Kay-Tee Khaw
  • Marc Gunter
  • Heinz Freisling
  • Inge Huybrechts
  • Dagfinn Aune
  • Amanda J Cross
  • Elio Riboli
  • Timothy J Key
Publishing year: 2017-07-15
Language: English
Pages: 287-297
Publication/Series: International Journal of Cancer
Volume: 141
Issue: 2
Document type: Journal article
Publisher: John Wiley & Sons

Abstract english

Several dietary factors have been studied in relation to prostate cancer; however, most studies have not reported on subtypes of fruit and vegetables or tumor characteristics, and results obtained so far are inconclusive. This study aimed to examine the prospective association of total and subtypes of fruit and vegetable intake with the incidence of prostate cancer overall, by grade and stage of disease, and prostate cancer death. Lifestyle information for 142,239 men participating in the European Prospective Investigation into Cancer and Nutrition from 8 European countries was collected at baseline. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average follow-up time of 13.9 years, 7,036 prostate cancer cases were identified. Compared with the lowest fifth, those in the highest fifth of total fruit intake had a significantly reduced prostate cancer risk (HR = 0.91; 95% CI = 0.83–0.99; p-trend = 0.01). No associations between fruit subtypes and prostate cancer risk were observed, except for citrus fruits, where a significant trend was found (HR = 0.94; 95% CI = 0.86–1.02; p-trend = 0.01). No associations between total and subtypes of vegetables and prostate cancer risk were observed. We found no evidence of heterogeneity in these associations by tumor grade and stage, with the exception of significant heterogeneity by tumor grade (pheterogeneity<0.001) for leafy vegetables. No significant associations with prostate cancer death were observed. The main finding of this prospective study was that a higher fruit intake was associated with a small reduction in prostate cancer risk. Whether this association is causal remains unclear.


  • Public Health, Global Health, Social Medicine and Epidemiology
  • fruit
  • prospective
  • prostate cancer
  • tumor subtypes
  • vegetable


  • Diabetes - Cardiovascular Disease
  • Clinical Chemistry, Malmö
  • ISSN: 0020-7136
Isabel Drake
E-mail: isabel [dot] drake [at] med [dot] lu [dot] se

Lund University Diabetes Centre, CRC, SUS Malmö, Jan Waldenströms gata 35, House 91:12. SE-214 28 Malmö. Telephone: +46 40 39 10 00