Vegetable intake and the risk of bladder cancer in the BLadder Cancer Epidemiology and Nutritional Determinants (BLEND) international study

Research output: Contribution to journalJournal articleResearchpeer-review

  • Evan Yi-Wen Yu
  • Anke Wesselius
  • Siamak Mehrkanoon
  • Mieke Goosens
  • Maree Brinkman
  • Piet van den Brandt
  • Eric J. Grant
  • Emily White
  • Elisabete Weiderpass
  • Florence Le Calvez-Kelm
  • Marc J. Gunter
  • Inge Huybrechts
  • Elio Riboli
  • Tjønneland, Anne
  • Giovanna Masala
  • Graham G. Giles
  • Roger L. Milne
  • Maurice P. Zeegers

Background Although a potential inverse association between vegetable intake and bladder cancer risk has been reported, epidemiological evidence is inconsistent. This research aimed to elucidate the association between vegetable intake and bladder cancer risk by conducting a pooled analysis of data from prospective cohort studies. Methods Vegetable intake in relation to bladder cancer risk was examined by pooling individual-level data from 13 cohort studies, comprising 3203 cases among a total of 555,685 participants. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were estimated using Cox proportional hazards regression models stratified by cohort for intakes of total vegetable, vegetable subtypes (i.e. non-starchy, starchy, green leafy and cruciferous vegetables) and individual vegetable types. In addition, a diet diversity score was used to assess the association of the varied types of vegetable intake on bladder cancer risk. Results The association between vegetable intake and bladder cancer risk differed by sex (P-interaction = 0.011) and smoking status (P-interaction = 0.038); therefore, analyses were stratified by sex and smoking status. With adjustment of age, sex, smoking, energy intake, ethnicity and other potential dietary factors, we found that higher intake of total and non-starchy vegetables were inversely associated with the risk of bladder cancer among women (comparing the highest with lowest intake tertile: HR = 0.79, 95% CI = 0.64-0.98, P = 0.037 for trend, HR per 1 SD increment = 0.89, 95% CI = 0.81-0.99; HR = 0.78, 95% CI = 0.63-0.97, P = 0.034 for trend, HR per 1 SD increment = 0.88, 95% CI = 0.79-0.98, respectively). However, no evidence of association was observed among men, and the intake of vegetable was not found to be associated with bladder cancer when stratified by smoking status. Moreover, we found no evidence of association for diet diversity with bladder cancer risk. Conclusion Higher intakes of total and non-starchy vegetable are associated with reduced risk of bladder cancer for women. Further studies are needed to clarify whether these results reflect causal processes and potential underlying mechanisms.

Original languageEnglish
Article number56
JournalBMC Medicine
Volume19
Issue number1
Number of pages15
ISSN1741-7015
DOIs
Publication statusPublished - 2021

    Research areas

  • Bladder cancer, Vegetable, Dietary diversity analysis, Cohort study

ID: 259010295