Consumption of vegetables and fruit and the risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition

Frederike L. Büchner, H. Bas Bueno-De-Mesquita, Martine M. Ros, Ellen Kampman, Lars Egevad, Kim Overvad, Ole Raaschou-Nielsen, Anne Tjønneland, Nina Roswall, Francoise Clavel-Chapelon, Marie Christine Boutron-Ruault, Marina Touillaud, Jenny Chang-Claude, Rudolf Kaaks, Heiner Boeing, Steffen Weikert, Antonia Trichopoulou, Pagona Lagiou, Dimitrios Trichopoulos, Domenico PalliSabina Sieri, Paolo Vineis, Rosario Tumino, Salvatore Panico, Alina Vrieling, Petra H M Peeters, Carla H. Van Gils, Eiliv Lund, Inger T. Gram, Dagrun Engeset, Carmen Martinez, Carlos A. Gonzalez, Nerea Larrañaga, Eva Ardanaz, Carmen Navarro, Laudina Rodríguez, Jonas Manjer, Roy A. Ehrnström, Goran Hallmans, Borje Ljungberg, Naomi E. Allen, Andrew W. Roddam, Sheila Bingham, Kay Tee Khaw, Nadia Slimani, Paolo Boffetta, Mazda Jenab, Traci Mouw, Dominique S. Michaud, Lambertus A L M Kiemeney, Elio Riboli

Research output: Contribution to journalArticlepeer-review


Previous epidemiologic studies found inconsistent associations between vegetables and fruit consumption and the risk of bladder cancer. We therefore investigated the association between vegetable and fruit consumption and the risk of bladder cancer among participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Data on food consumption and complete follow-up for cancer occurrence was available for a total of 478,533 participants, who were recruited in 10 European countries. Estimates of rate ratios were obtained by Cox proportional hazard models, stratified by age at recruitment, gender and study centre, and adjusted for total energy intake, smoking status, duration of smoking and lifetime intensity of smoking. A calibration study in a subsample was used to control for dietary measurement errors. After a mean follow-up of 8.7 years, 1015 participants were newly diagnosed with bladder cancer. Increments of 100 g/day in fruit and vegetable consumption combined did not affect bladder cancer risk (i.e., calibrated HR = 0.98; 95%CI: 0.95-1.01). Borderline statistically significant lower bladder cancer risks were found among never smokers with increased consumption of fruit and vegetables combined (HR = 0.94 95%CI: 0.87-1.00 with increments of 100 g/day; calibrated HR = 0.92 95%CI 0.79-1.06) and increased consumption of apples and pears (hard fruit; calibrated HR 5 0.90 95%CI: 0.82-0.98 with increments of 25 g/day). For none of the associations a statistically significant interaction with smoking status was found. Our findings do not support an effect of fruit and vegetable consumption, combined or separately, on bladder cancer risk.

Original languageEnglish
Pages (from-to)2643-2651
Number of pages9
JournalInternational Journal of Cancer
Issue number11
Publication statusPublished - Dec 1 2009


  • Bladder cancer
  • EPIC
  • Fruit
  • Vegetables

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)


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