Attributable causes of cancer in China: Fruit and vegetable

Objective: To provide an evidence-based and consistent assessment of the burden of cancer attributable to inadequate fruit and vegetable intake in China in 2005. Methods: The proportions of cancers attributable to low consumption of vegetable and fruit were calculated separately to estimate the burden of related cancers for the year 2005 in China. Data on the prevalence of exposure were derived from a Chinese nutrition and health survey. Data on relative risks were mainly derived from meta-analysis. Attributable fractions were calculated based on the counterfactual scenario which was a shift in the exposure distribution. Results: The total cancer burden attributable to inadequate consumption of fruit was up to 233,000 deaths (13.0% of all cancers) and 300,000 cases (11.6% of all cancers) in 2005. Increasing consumption of vegetable to the highest quintile could avoid total cancer deaths and cases by 3.6% (64,000 persons) and 3.4% (88,000 persons). The contributions to cancer burden were higher in rural areas than in urban areas. They have greater influence on men than on women. The largest proportions of cancer burden attributable to low fruit and vegetable intake were for oral ai]and pharyngeal cancers. Conclusion: This study showed that inadequate intake of fruit and vegetable makes a significant contribution to the cancer burden. Increasing consumption of fruit and vegetable could prevent many cancer deaths and save many lives. Promoting the consumption of fruit and vegetable is an important component in diet-based strategies for preventing cancer.