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Observational epidemiological surveys (WG 3) page 9
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Table 2: Level of evidence of protection provided by studies on fruit and
vegetables and cancers
cancer sites CNERNA
World Cancer Res COMA Food and Nutrition
(France, 1996) Fund (USA, 1997) Policy (UK, 1998)
mouth and consistent convincing fruit: weakly consistent;
pharynx
vegetables: inconsistent
larynx consistent probable moderately consistent
oesophagus consistent convincing strongly consistent
lung and
respiratory tract
consistent convincing fruit: moderately consistent
vegetables: weakly
consistent
stomach consistent convincing moderately consistent
colon-rectum vegetables:
vegetables: vegetables: moderately to
moderately consistent convincing weakly consistent
pancreas consistent probable consistent but limited
liver ND vegetables only:
possible
ND
breast inconsistent green vegetables: green/yellow vegetables:
probable moderately consistent
ovary inconsistent possible inconsistent
endometrium inconsistent insufficient inconsistent
cervix ND possible consistent but limited
prostate inconsistent vegetables: vegetables: moderately
possible
consistent but limited
kidney ND vegetables only:
possible
ND
bladder ND probable moderately consistent but
limited
thyroid
ND: Not Done
ND possible ND
• For colon and rectum cancers, the three sources agreed that fruit had no
relationship with these cancers. However, there was a disagreement on the level of risk
reduction provided by vegetables. The reading of the original articles showed that WRCF
proposed convincing effect for vegetables although half of the cohort studies did not show
reduction of risk with a high intake of vegetables.
• For all of the hormone-dependent cancers, breast, ovary, endometrium and
prostate, CNERNA found no relationship with intake of vegetables. This opinion was shared
by COMA for ovary and endometrium cancers. The relationship is judged possible by WCRF
for ovary cancer although they quoted that not all studies were significant. For endometrium
cancer, results are more inconsistent than insufficient. For breast cancer, there was a total
agreement on the absence of effect from fruit. For vegetables, the results of a few cohort
studies overwhelmed those of case-control studies in WCRF and COMA. However, certain
studies indicated that compounds other than carotenoids are the likely agents of reduction of
risk. For prostate cancer, the findings mainly differed by type of vegetables, therefore they