@article{3089839,
    title = "Variety in vegetable and fruit consumption and risk of bladder cancer in the European Prospective Investigation into Cancer and Nutrition",
    author = "Büchner, F.L. and Bueno-De-Mesquita, H.B. and Ros, M.M. and Kampman, E. and Egevad, L. and Overvad, K. and Tjãnneland, A. and Roswall, N. and Clavel-Chapelon, F. and Boutron-Ruault, M.-C. and Touillaud, M. and Kaaks, R. and Chang-Claude, J. and Boeing, H. and Weikert, S. and Trichopoulou, A. and Naska, A. and Benetou, V. and Palli, D. and Sieri, S. and Vineis, P. and Tumino, R. and Panico, S. and Van Duijnhoven, F.J.B. and Peeters, P.H.M. and Van Gils, C.H. and Lund, E. and Gram, I.T. and Sánchez, M.-J. and Jakszyn, P. and Larrañaga, N. and Ardanaz, E. and Navarro, C. and Rodríguez, L. and Manjer, J. and Ehrnström, R. and Hallmans, G. and Ljungberg, B. and Key, T.J. and Allen, N.E. and Khaw, K.-T. and Wareham, N. and Slimani, N. and Jenab, M. and Boffetta, P. and Kiemeney, L.A.L.M. and Riboli, E.",
    journal = "International Journal  of Cancer",
    year = "2011",
    volume = "128",
    number = "12",
    pages = "2971-2979",
    issn = "0020-7136",
    doi = "10.1002/ijc.25636",
    keywords = "adult;  aged;  article;  bladder cancer;  cancer incidence;  cancer risk;  controlled study;  education;  environmental factor;  Europe;  feeding behavior;  female;  food intake;  fruit;  human;  lifestyle;  major clinical study;  male;  nutrition;  nutritional assessment;  physical activity;  priority journal;  risk assessment;  sex difference;  transitional cell carcinoma;  vegetable, Diet;  Europe;  Female;  Fruit;  Humans;  Life Style;  Male;  Prospective Studies;  Risk Factors;  Urinary Bladder Neoplasms;  Vegetables",
    abstract = "Recent research does not show an association between fruit and vegetable consumption and bladder cancer risk. None of these studies investigated variety in fruit and vegetable consumption, which may capture different aspects of consumption. We investigated whether a varied consumption of vegetables and fruits is associated with bladder cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Detailed data on food consumption and complete follow-up for cancer incidence were available for 452,185 participants, who were recruited from ten European countries. After a mean follow-up of 8.7 years, 874 participants were diagnosed with bladder cancer. Diet diversity scores (DDSs) were used to quantify the variety in fruit and vegetable consumption. Multivariable Cox proportional hazard models were used to assess the effect of the DDSs on bladder cancer risk. There was no evidence of a statistically significant association between bladder cancer risk and any of the DDSs when these scores were considered as continuous covariates. However, the hazard ratio (HR) for the highest tertile of the DDS for combined fruit and vegetable consumption was marginally significant compared to the lowest (HR = 1.30, 95% confidence interval: 1.00-1.69, p-trend = 0.05). In EPIC, there is no clear association between a varied fruit and vegetable consumption and bladder cancer risk. This finding provides further evidence for the absence of any strong association between fruit and vegetable consumption as measured by a food frequency questionnaire and bladder cancer risk. © 2010 UICC."
}