@article{3165379,
    title = "Fruit and vegetable consumption in relation to hepatocellular carcinoma
in a multi-centre, European cohort study",
    author = "Bamia, C. and Lagiou, P. and Jenab, M. and Aleksandrova, K. and Fedirko, and V. and Trichopoulos, D. and Overvad, K. and Tjonneland, A. and Olsen, A. and and Clavel-Chapelon, F. and Boutron-Ruault, M-C and Kvaskoff, M. and and Katzke, V. A. and Kuehn, T. and Boeing, H. and Noethlings, U. and Palli, and D. and Sieri, S. and Panico, S. and Tumino, R. and Naccarati, A. and and Bueno-de-Mesquita, H. B(As) and Peeters, P. H. M. and Weiderpass, E. and and Skeie, G. and Quiros, J. R. and Agudo, A. and Chirlaque, M-D and and Sanchez, M-J and Ardanaz, E. and Dorronsoro, M. and Ericson, U. and and Nilsson, L. M. and Wennberg, M. and Khaw, K-T and Wareham, N. and Key, and T. J. and Travis, R. C. and Ferrari, P. and Stepien, M. and and Duarte-Salles, T. and Norat, T. and Murphy, N. and Riboli, E. and and Trichopoulou, A.",
    journal = "British Journal of Cancer",
    year = "2015",
    volume = "112",
    number = "7",
    pages = "1273-1282",
    publisher = "Nature Publishing Group",
    issn = "0007-0920, 1532-1827",
    doi = "10.1038/bjc.2014.654",
    keywords = "hepatocellular carcinoma; liver cancer; vegetable; fruit; EPIC; cohort",
    abstract = "Background: Vegetable and/or fruit intakes in association with
hepatocellular carcinoma (HCC) risk have been investigated in
case-control studies conducted in specific European countries and cohort
studies conducted in Asia, with inconclusive results. No multi-centre
European cohort has investigated the indicated associations.
Methods: In 486 799 men/women from the European Prospective
Investigation into Cancer and nutrition, we identified 201 HCC cases
after 11 years median follow-up. We calculated adjusted hazard ratios
(HRs) for HCC incidence for sex-specific quintiles and per 100 g d(-1)
increments of vegetable/fruit intakes.
Results: Higher vegetable intake was associated with a statistically
significant, monotonic reduction of HCC risk: HR (100 g d(-1)
increment): 0.83; 95% CI: 0.71-0.98. This association was consistent in
sensitivity analyses with no apparent heterogeneity across strata of HCC
risk factors. Fruit intake was not associated with HCC incidence: HR
(100 g d(-1) increment): 1.01; 95% CI: 0.92-1.11.
Conclusions: Vegetable, but not fruit, intake is associated with lower
HCC risk with no evidence for heterogeneity of this association in
strata of important HCC risk factors. Mechanistic studies should clarify
pathways underlying this association. Given that HCC prognosis is poor
and that vegetables are practically universally accessible, our results
may be important, especially for those at high risk for the disease."
}