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Prostate cancer incidence and intake of fruits, vegetables and related micronutrients: the multiethnic cohort study* (United States)

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Abstract

Objective

To describe the relationship between the intake of fruits, vegetables, and related vitamins and antioxidants, and the risk of prostate cancer in male participants in a large multiethnic cohort study.

Methods

Food and nutrient intakes in 1993–1996 were calculated from a detailed food frequency questionnaire (FFQ) designed to account for the food and nutrient intake of the ethnic groups represented in the study (82,486 African-American, Japanese-American, Native-Hawaiian, Latino and White males included here). Follow-up for incident cancers utilized local SEER registries. Vital status was ascertained using state death files. Data on PSA utilization from a later questionnaire was also examined.

Results

A total of 3,922 incident cancer cases were ascertained during follow-up. Modestly increased risks of prostate cancer were observed in relation to higher intakes of several food items including light green lettuce and dark leafy green vegetables. Notably, no significant protective associations of any foods were seen, including tomato intake; and intakes of two complex foods containing tomato sauce (pizza and Spanish rice) were associated with modest increases in risk. PSA test use was significantly and positively related to intake of some of these same items, implying a degree of disease detection-bias. Analysis of non-localized and high grade disease (1,345 cases) showed no significant protective associations with overall fruits and vegetables intake, related micronutrients, or with intake of selected complex food items.

Conclusions

We found no statistically significant evidence of a protective effect against prostate cancer of higher levels of intake of any of these foods, associated micronutrients or supplements. A possible explanation for the positive associations with risk of several of the foods normally considered to be healthy is detection bias, since “healthy” dietary intake was related to greater use of the PSA test.

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Acknowledgments

This work has been supported by R01 CA 54281, Multiethnic/Minority Cohort Study of Diet and Cancer. Special thanks to Dr. Kris Monroe and Faye Nagamine for study coordination and administration, and to Stuart Wugalter for statistical programming. We are indebted to the members of the Multiethnic Cohort Study for their participation and ongoing commitment.

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Authors and Affiliations

  1. Department of Preventive Medicine, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA

    Daniel O. Stram, Brian E. Henderson & Malcolm C. Pike

  2. Cancer Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI, 96813, USA

    Jean H. Hankin, Lynne R. Wilkens, Abraham M. Y. Nomura & Laurence N. Kolonel

  3. Cancer Biostatistics Branch, Cancer Cohort Study Branch, National Cancer Center, Seoul, Korea

    Sohee Park

  4. USC/KECK Division of Biostatistics, 1540 Alcazar Street, Room 220G, Los Angeles, CA, 90033, USA

    Daniel O. Stram

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  1. Daniel O. Stram
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  2. Jean H. Hankin
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  4. Sohee Park
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  8. Laurence N. Kolonel
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Corresponding author

Correspondence to Daniel O. Stram.

Additional information

*Supported by Public Health Service (National Cancer Institute) grant R01 CA 54281.

Appendix

Appendix

Table 7 Quintile or other cutpoints used for foods, nutrients, and supplements. Cutpoints for Categorization of Foods, Nutrients, and Supplements by Level of Intake. Categories (quintiles, etc.) are defined as (intake ≤C1, C1<intake≤C2, C2<intake≤C3, C3<intake≤C4, intake > C4). Percentages indicate the fraction of subjects with zero intake of the less commonly consumed foods or supplements
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Stram, D.O., Hankin, J.H., Wilkens, L.R. et al. Prostate cancer incidence and intake of fruits, vegetables and related micronutrients: the multiethnic cohort study* (United States). Cancer Causes Control 17, 1193–1207 (2006). https://doi.org/10.1007/s10552-006-0064-0

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  • DOI: https://doi.org/10.1007/s10552-006-0064-0

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