Association of vegetable and fruit intake with gastric cancer risk among Japanese: a pooled analysis of four cohort studies

Ann Oncol. 2014 Jun;25(6):1228-33. doi: 10.1093/annonc/mdu115. Epub 2014 Mar 11.


Background: Prospective evidence is inconsistent regarding the association between vegetable/fruit intake and the risk of gastric cancer.

Methods: In an analysis of original data from four population-based prospective cohort studies encompassing 191 232 participants, we used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of gastric cancer incidence according to vegetable and fruit intake and conducted a meta-analysis of HRs derived from each study.

Results: During 2 094 428 person-years of follow-up, 2995 gastric cancer cases were identified. After adjustment for potential confounders, we found a marginally significant decrease in gastric cancer risk in relation to total vegetable intake but not total fruit intake: the multivariate-adjusted HR (95% CI; P for trend) for the highest versus the lowest quintile of total vegetable intake was 0.89 (0.77-1.03; P for trend = 0.13) among men and 0.83 (0.67-1.03; P for trend = 0.40) among women. For distal gastric cancer, the multivariate HR for the highest quintile of total vegetable intake was 0.78 (0.63-0.97; P for trend = 0.02) among men.

Conclusions: This pooled analysis of data from large prospective studies in Japan suggests that vegetable intake reduces gastric cancer risk, especially the risk of distal gastric cancer among men.

Keywords: epidemiology; fruit; pooled analysis; prospective studies; stomach neoplasms; vegetables.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asian People
  • Cohort Studies
  • Diet Surveys
  • Diet*
  • Female
  • Fruit*
  • Humans
  • Incidence
  • Male
  • Proportional Hazards Models
  • Risk Factors
  • Stomach Neoplasms / epidemiology*
  • Surveys and Questionnaires
  • Vegetables*