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Fruit and vegetable intake and breast cancer risk defined by estrogen and progesterone receptor status: the Japan Public Health Center-based Prospective Study

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Abstract

Background

Epidemiological evidence for the impact of fruit and vegetable intake on breast cancer risk among the Japanese populations is scarce.

Objective

The purpose of this study was to evaluate the association between fruit and vegetable intake and breast cancer risk among 47,289 Japanese women.

Design

The study was conducted under a population-based prospective cohort design. Dietary assessment was performed using a validated food frequency questionnaire. A Cox proportional hazards regression model was used to calculate relative risks (RRs) and their corresponding 95 % confidence intervals (CIs).

Results

During an average of 10.2 years of follow-up, 452 cases of breast cancer were newly diagnosed. No association with breast cancer risk was seen for intake of total fruits and vegetables, cruciferous vegetables, green-leaf vegetables, yellow vegetables, or tomato products in overall or postmenopausal women. Cruciferous vegetable intake was associated with a statistically significant decrease in risk of premenopausal breast cancer [multivariable-RRQ4 vs. Q1 = 0.64 (95 % CI = 0.38–1.10; p trend = .046)] and showed a marginally inverse association with ER+ PR+ tumors [RRper 100 g increment = 0.64 (95 % CI = 0.41–1.00)]. In contrast, positive associations were seen between intake of total fruits and citrus fruits and breast cancer risk in overall and premenopausal women. However, these associations for fruit were all attenuated with additional adjustment for vitamin C intake.

Conclusions

Our results suggest an overall null association between total fruit and vegetable intake and breast cancer risk. Intake of cruciferous vegetable showed a statistically significant association with a decreased risk of breast cancer among premenopausal women.

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Abbreviations

BMI:

Body mass index

CIs:

Confidence intervals

ER:

Estrogen receptor

EFH:

Exogenous female hormones

FFQ:

Food frequency questionnaire

The JPHC Study:

The Japan Public Health Center-based Prospective Study

OC:

Oral contraceptive

PR:

Progesterone receptor

RR:

Relative risk

SD:

Standard deviation

DCN:

Death certificate notification

DCO:

Death certificate only

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Acknowledgments

We thank all staff members in each study area and in the central offices for their cooperation and technical assistance. We also wish to thank the Iwate, Akita, Ibaraki, Niigata, Osaka, Kochi, Nagasaki and Okinawa Cancer Registries for their provision of incidence data. RS, MI, and ST designed the research; ST conducted research; RS analyzed data; RS wrote the paper; RS, MI and ST were primarily responsibility for final content. All authors read and approved the final manuscript. Our study was supported by grants-in-aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan, for Scientific Research on Priority Areas from the Ministry of Education, Culture, Sports, Science, and Technology of Japan, and for the 3rd Term Comprehensive 10-Year- Strategy for Cancer Control from the Ministry of Health, Labour and Welfare of Japan. RS received a Grant-in-Aid from the Japan Society for the Promotion of Science Fellowship (H23).

Conflict of interest

The authors declare no conflict of interest related to this manuscript.

Author information

Authors and Affiliations

  1. Division of Medical Nutrition, Department of Medical Healthcare, Tokyo Healthcare University, 3-11-3 Setagaya, Setagaya-ku, Tokyo, Japan

    Reiko Suzuki

  2. Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Motoki Iwasaki, Azusa Hara, Manami Inoue, Shizuka Sasazuki, Norie Sawada, Taiki Yamaji, Taichi Shimazu & Shoichiro Tsugane

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  1. Reiko Suzuki
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  2. Motoki Iwasaki
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  3. Azusa Hara
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Japan Public Health Center-based Prospective Study Group

Corresponding author

Correspondence to Motoki Iwasaki.

Appendix

Appendix

Members of the Japan Public Health Center-based Prospective Study Group (principal investigator: S. Tsugane): S. Tsugane, M. Inoue, T. Sobue, and T. Hanaoka, National Cancer Center, Tokyo; J. Ogata, S. Baba, T. Mannami, A. Okayama, and Y. Kokubo, National Cardiovascular Center, Osaka; K. Miyakawa, F. Saito, A. Koizumi, Y. Sano, I. Hashimoto, and T. Ikuta, Iwate Prefectural Ninohe Public Health Center, Iwate; Y. Miyajima, N. Suzuki, S. Nagasawa, Y. Furusugi, and N. Nagai, Akita Prefectural Yokote Public Health Center, Akita; H. Sanada, Y. Hatayama, F. Kobayashi, H. Uchino, Y. Shirai, T. Kondo, R. Sasaki, Y. Watanabe, Y. Miyagawa, and Y. Kobayashi, Nagano Prefectural Saku Public Health Center, Nagano; Y. Kishimoto, E. Takara, T. Fukuyama, M. Kinjo, M. Irei, and H. Sakiyama, Okinawa Prefectural Chubu Public Health Center, Okinawa; K. Imoto, H. Yazawa, T. Seo, A. Seiko, F. Ito, and F. Shoji, Katsushika Public Health Center, Tokyo; A. Murata, K. Minato, K. Motegi, and T. Fujieda, Ibaraki Prefectural Mito Public Health Center, Ibaraki; K. Matsui, T. Abe, M. Katagiri, and M. Suzuki, Niigata Prefectural Kashiwazaki and Nagaoka Public Health Center, Niigata; M. Doi, A. Terao, Y. Ishikawa, and T. Tagami, Kochi Prefectural Chuo-higashi Public Health Center, Kochi; H. Sueta, H. Doi, M. Urata, N. Okamoto, and F. Ide, Nagasaki Prefectural Kamigoto Public Health Center, Nagasaki; H. Sakiyama, N. Onga, H. Takaesu, and M. Uehara, Okinawa Prefectural Miyako Public Health Center, Okinawa; F. Horii, I. Asano, H. Yamaguchi, K. Aoki, S. Maruyama, M. Ichii, and M. Takano, Osaka Prefectural Suita Public Health Center, Osaka; S. Matsushima and S. Natsukawa, Saku General Hospital, Nagano; K. Suzuki, Research Institute for Brain and Blood Vessels Akita, Akita; M. Kabuto, National Institute for Environmental Studies, Ibaraki; M. Yamaguchi, Y. Matsumura, S. Sasaki, and S. Watanabe, National Institute of Health and Nutrition, Tokyo; M. Noda, International Medical Center of Japan, Tokyo; S. Tominaga, Aichi Cancer Center Research Institute, Aichi; H. Shimizu, Sakihae Institute, Gifu; M. Iida, W. Ajiki, and A. Ioka, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka; S. Sato, Osaka Medical Center for Health Science and Promotion, Osaka; Y. Tsubono, Tohoku University, Miyagi; K. Nakamura, Niigata University, Niigata; Y. Honda, K. Yamagishi, and S. Sakurai, Tsukuba University, Ibaraki; M. Akabane, Tokyo University of Agriculture, Tokyo; T. Kadowaki, Tokyo University, Tokyo; Y. Kawaguchi, Tokyo Medical and Dental University, Tokyo; Y. Takashima, Kyorin University, Tokyo; H. Sugimura, Hamamatsu University, Shizuoka; H. Iso, Osaka University, Osaka; E. Maruyama, Kobe University, Hyogo; M. Konishi, K. Okada, and I. Saito, Ehime University, Ehime; N. Yasuda, Kochi University, Kochi; and S. Kono, Kyushu University, Fukuoka.

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Suzuki, R., Iwasaki, M., Hara, A. et al. Fruit and vegetable intake and breast cancer risk defined by estrogen and progesterone receptor status: the Japan Public Health Center-based Prospective Study. Cancer Causes Control 24, 2117–2128 (2013). https://doi.org/10.1007/s10552-013-0289-7

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