• 9/2/2006
  • Baltimore, MD
  • Nancy Nairi Maserejian et al.
  • American Journal of Epidemiology 2006 164(6):556-566; doi:10.1093/aje/kwj233

The authors prospectively evaluated fruit and vegetable consumption and the incidence of oral premalignant lesions among 42,311 US men in the Health Professionals Follow-up Study. Diet was assessed every 4 years by food frequency questionnaires.

The authors confirmed 207 cases of clinically or histopathologically diagnosed oral premalignant lesions occurring between 1986 and 2002. Multivariate-adjusted relative risks were calculated from proportional hazards models.

Significant inverse associations were observed with citrus fruits, citrus fruit juice, and vitamin-C-rich fruits and vegetables, indicating 30–40% lower risks with greater intakes (e.g., citrus fruit juice quintile 5 vs. quintile 1 relative risk = 0.65, 95% confidence interval: 0.42, 0.99).

Inverse associations with fruits did not vary by smoking status and were stronger in analyses of baseline consumption, with a 10-year lag time to disease follow-up (quintile 5 vs. quintile 1 relative risk = 0.41, 95% confidence interval: 0.20, 0.82; p = 0.01). No associations were observed with total vegetables or with ß-carotene-rich or lycopene-rich fruits and vegetables.

For current smokers, green leafy vegetables (ptrend = 0.05) and ß-carotene-rich fruits and vegetables (ptrend = 0.02) showed significant linear trends of increased risk (one additional serving/day relative risk = 1.7).

The risk of oral premalignant lesions was significantly reduced with higher consumption of fruits, particularly citrus fruits and juices, while no consistent associations were apparent for vegetables.

Authors:
Nancy Nairi Maserejian1,2,3, Edward Giovannucci1,4,5, Bernard Rosner4, Athanasios Zavras2 and Kaumudi Joshipura1,2,6

Authors’ affiliations:
1 Department of Epidemiology, Harvard School of Public Health, Boston, MA
2 Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA
3 New England Research Institutes, Watertown, MA
4 Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
5 Department of Nutrition, Harvard School of Public Health, Boston, MA
6 Division of Dental Public Health, School of Dentistry, University of Puerto Rico Medical Sciences, San Juan, PR