Fruits and vegetables intake and gastric cancer risk: A pooled analysis within the Stomach cancer Pooling Project

Roberto Persiani, Stefania Boccia, Pagona Lagiou, Paolo Boffetta, Erica Negri, Nuno Miguel De Sousa Lunet, Ana Ferro, Ana Rute Costa, Samantha Morais, Paola Bertuccio, Matteo Rota, Claudio Pelucchi, Jinfu Hu, Kenneth C. Johnson, Zuo-Feng Zhang, Domenico Palli, Monica Ferraroni, Guo-Pei Yu, Rossella Bonzi, Bárbara PeleteiroLizbeth López-Carrillo, Shoichiro Tsugane, Gerson Shigueaki Hamada, Akihisa Hidaka, Reza Malekzadeh, David Zaridze, Dmitry Maximovich, Jesus Vioque, Eva M. Navarrete-Muñoz, Juan Alguacil, Gemma Castaño-Vinyals, Alicja Wolk, Niclas Håkansson, Raúl Ulises Hernández-Ramírez, Mohammadreza Pakseresht, Mary H. Ward, Farhad Pourfarzi, Lina Mu, Malaquias López-Cervantes, Robert C. Kurtz, Areti Lagiou, Eva Negri, Maria Constanza Camargo, Maria Paula Curado, Carlo La Vecchia, Nuno Lunet

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4 Citations (Scopus)


A low intake of fruits and vegetables is a risk factor for gastric cancer, although there is uncertainty regarding the magnitude of the associations. In our study, the relationship between fruits and vegetables intake and gastric cancer was assessed, complementing a previous work on the association betweenconsumption of citrus fruits and gastric cancer. Data from 25 studies (8456 cases and 21 133 controls) with information on fruits and/or vegetables intake were used. A two-stage approach based on random-effects models was used to pool study-specific adjusted (sex, age and the main known risk factors for gastric cancer) odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Exposure-response relations, including linear and nonlinear associations, were modeled using one- and two-order fractional polynomials. Gastric cancer risk was lower for a higher intake of fruits (OR: 0.76, 95% CI: 0.64-0.90), noncitrus fruits (OR: 0.86, 95% CI: 0.73-1.02), vegetables (OR: 0.68, 95% CI: 0.56-0.84), and fruits and vegetables (OR: 0.61, 95% CI: 0.49-0.75); results were consistent across sociodemographic and lifestyles categories, as well as study characteristics. Exposure-response analyses showed an increasingly protective effect of portions/day of fruits (OR: 0.64, 95% CI: 0.57-0.73 for six portions), noncitrus fruits (OR: 0.71, 95% CI: 0.61-0.83 for six portions) and vegetables (OR: 0.51, 95% CI: 0.43-0.60 for 10 portions). A protective effect of all fruits, noncitrus fruits and vegetables was confirmed, supporting further dietary recommendations to decrease the burden of gastric cancer.
Original languageEnglish
Pages (from-to)3090-3101
Number of pages12
JournalInternational Journal of Cancer
Publication statusPublished - 2020


  • fruits
  • gastric cancer
  • vegetables
  • pooled analyses
  • nutrition


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