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Observational epidemiological surveys (WG 3) page 7
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This part consisted of:
1. Summary of the data provided by the four reference books (CNERNA, 1996; World
Cancer Res Fund, 1997; COMA Food and Nutrition Policy, 1998; Carotenoids, IARC,
1998) accompanied with comments and comparison and conclusion.
2. Up-dating of these data with studies reported since 1996.
3. Major intervention trials
4. Synthetic conclusion.
1-1 SUMMARY OF THE DATA PROVIDED BY THE THREE REFERENCE BOOKS
1-1-1 Tomatoes and tomato products (Table 1)
Comments on table 1
The specific effect of tomatoes was never considered in the COMA and was once considered
in the CNERNA (a multicentric study conducted in Latin America showed a protective effect
of tomatoes and other fruit-vegetables). Tomatoes were specifically quoted for 11 cancer sites
in the WCRF book. However, there were less than three studies for most cancer sites and the
conclusion was insufficient. For mouth and pharynx, there were three studies mentioning
tomatoes; of these, two showed an inverse relationship, and one study showed a positive
relationship. Altogether, the three studies for oesophagus and the four studies for lung and
respiratory tract showed a reduced risk associated with a high tomato intake. Among the 11
studies considering the relationship between a high tomato intake and stomach cancer, 9
studies demonstrated a reduced risk, one study showed no relationship, and one study showed
a positive association. Thus for these three localisations, results were said to be convincing.
Only one of these studies (Giovanucci et al., 1995) stated whether the tomatoes were raw,
cooked or processed.
Table 1: Level of evidence of protection provided by studies on the relationship between
tomatoes, tomato products and cancers
cancer sites CNERNA
World Cancer Res
(France, 1996) Fund (USA, 1997)
mouth and pharynx NM possible
larynx insufficient insufficient
lung and resp. tract NM convincing