Environment and Breast Cancer: Science Review

Evidence From Humans
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Consumption of vegetables and fruits and risk of breast cancer
van Gils, C. H., Peeters, P. H., Bueno-de-Mesquita, H. B., Boshuizen, H. C., Lahmann, P. H., Clavel-Chapelon, F., Thiebaut, A., Kesse, E., Sieri, S., Palli, D., Tumino, R., Panico, S., Vineis, P., Gonzalez, C. A., Ardanaz, E., Sanchez, M. J., Amiano, P., Navarro, C., Quiros, J. R., Key, T. J., Allen, N., Khaw, K. T., Bingham, S. A., Psaltopoulou, T., Koliva, M., Trichopoulou, A., Nagel, G., Linseisen, J., Boeing, H., Berglund, G., Wirfalt, E., Hallmans, G., Lenner, P., Overvad, K., Tjonneland, A., Olsen, A., Lund, E., Engeset, D., Alsaker, E., Norat, T., Kaaks, R., Slimani, N., Riboli, E. Jama. 2005. 293:2, 183-93.
Study design
Prospective cohort
Funding agency
Other: Many
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Pre menopausal
Number in Cohort
Cohort 285,526
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Women aged 25-70 years participating in the multicenter EPIC study (23 centers in 10 European countries). Ex: Women with prevalent cancer at any site at baseline, who did not fill out the dietary or nondietary questionnaires, or if they were in the top or bottom 1% of the ratio of energy intake to energy requirement. The centers in Greece and Norway were excluded because of the small number of cases accruing there from a short follow-up.
Exposure Investigated
Exposures investigated
Fruits and vegetables
How exposure was measured
Questionnaire, in person Questionnaire, self-administered
Exposure assessment comment
Different questionnaire designs and follow-up procedure in each center
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: BMI, race, family history of breast cancer
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 RR with 95% CI, highest versus lowest quintile of intake, subgroup for type of fruits and vegetables, interaction between BMI and fruits and vegetables, stratified by center, mean follow-up 5.4 years
Strength of associations reported
Total vegetables: 0.98 (0.84-1.14); total fruits: 1.09 (0.94-1.25)
Results Comments
No association of risk of breast cancer with consumption of fruits and vegetables.
Author address
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.