Environment and Breast Cancer: Science Review

Evidence From Humans
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Intake of fruits and vegetables and risk of breast cancer: a pooled analysis of cohort studies
Smith-Warner, S. A., Spiegelman, D., Yaun, S. S., Adami, H. O., Beeson, W. L., van den Brandt, P. A., Folsom, A. R., Fraser, G. E., Freudenheim, J. L., Goldbohm, R. A., Graham, S., Miller, A. B., Potter, J. D., Rohan, T. E., Speizer, F. E., Toniolo, P., Willett, W. C., Wolk, A., Zeleniuch-Jacquotte, A., Hunter, D. J. JAMA. 2001. 285:6, 769-76.
Study design
Pooled analysis of 9 cohort studies
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Country where study was conducted
6 USA, 1 Canada, 1 Sweden, 1 Netherlands
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Pooling Project. Studies with at least 200 incident breast cancer cases, assessment of usual intake of foods and nutrients, validation study of the diet assessment method or a closely related instrument Ex: Criteria used by each study, and participants reporting energy intakes greater or less than 3 standard deviations from the study specific log.e-transformed mean energy intake of the baseline population, had missing alcohol intake data or reported a history of cancer (except non-melanoma skin cancer) at baseline
Exposure Investigated
Exposures investigated
Fruits and vegetables together, fruits, and vegetables
How exposure was measured
Questionnaire, self-administered, FFQ
Exposure assessment comment
FFQ: 45 to 150 food items
Statistical Analysis
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Not considered: Race
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Description of major analysis
Adjusted IRR with 95% CI, modeled as continuous variable for 100 g/day increase of intake and in quartiles (highest versus the lowest).
Strength of associations reported
Continuous variable: Fruits and vegetables: 1.00 (0.98 - 1.01); fruits: 1.00 (0.97 - 1.02); vegetables: 1.00 (0.97 - 1.02)
Highest versus lowest quartiles: Fruits and vegetables: 0.93 (0.86 - 1.00); fruits: 0.93 (0.84 - 1.02); vegetables: 0.96 (0.89- 1.04)
Results Comments
Fruit and vegetable consumption is not associated with breast cancer risk.
Author address
Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA.