Consumption of fruits, vegetables and fruit juices and differentiated thyroid carcinoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Research output: Contribution to journalArticle


Fruit and vegetable (F&V) intake is considered as probably protective against overall cancer risk, but results in previous studies are not consistent for thyroid cancer (TC). The purpose of this study is to examine the association between the consumption of fruits, vegetables, fruit juices and differentiated thyroid cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The EPIC study is a cohort including over half a million participants, recruited between 1991 and 2000. During a mean follow-up of 14 years, 748 incident first primary differentiated TC cases were identified. F&V and fruit juice intakes were assessed through validated country-specific dietary questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models adjusted for potential confounding factors. Comparing the highest versus lowest quartile of intake, differentiated TC risk was not associated with intakes of total F&V (HR: 0.89; 95% CI: 0.68–1.15; p-trend = 0.44), vegetables (HR: 0.89; 95% CI: 0.69–1.14; p-trend = 0.56), or fruit (HR: 1.00; 95% CI: 0.79–1.26; p-trend = 0.64). No significant association was observed with any individual type of vegetable or fruit. However, there was a positive borderline trend with fruit juice intake (HR: 1.23; 95% CI: 0.98–1.53; p-trend = 0.06). This study did not find any significant association between F&V intakes and differentiated TC risk; however a positive trend with fruit juice intake was observed, possibly related to its high sugar content.


  • Raul Zamora-Ros
  • Virginie Béraud
  • Silvia Franceschi
  • Valerie Cayssials
  • Konstantinos K. Tsilidis
  • Marie Christine Boutron-Ruault
  • Elisabete Weiderpass
  • Kim Overvad
  • Anne Tjønneland
  • Anne K. Eriksen
  • Fabrice Bonnet
  • Aurélie Affret
  • Verena Katzke
  • Tilman Kühn
  • Heiner Boeing
  • Antonia Trichopoulou
  • Elisavet Valanou
  • Anna Karakatsani
  • Giovanna Masala
  • Sara Grioni
  • Maria Santucci de Magistris
  • Rosario Tumino
  • Fulvio Ricceri
  • Guri Skeie
  • Christine L. Parr
  • Susana Merino
  • Elena Salamanca-Fernández
  • Maria Dolores Chirlaque
  • Eva Ardanaz
  • Pilar Amiano
  • Joakim Hennings
  • Maria Sandström
  • H. Bas Bueno-de-Mesquita
  • Petra H. Peeters
  • Kay Thee Khaw
  • Nicholas J. Wareham
  • Julie A. Schmidt
  • Aurora Perez-Cornago
  • Dagfinn Aune
  • Elio Riboli
  • Nadia Slimani
  • Augustin Scalbert
  • Isabelle Romieu
  • Antonio Agudo
  • Sabina Rinaldi
External organisations
  • Bellvitge Biomedical Research Institute
  • International Agency for Research on Cancer, World Health Organization
  • University of Ioannina
  • Imperial College London
  • University of Paris-Sud
  • Institut Gustave Roussy
  • UiT The Arctic University of Norway, Tromsø
  • Cancer Registry of Norway Institute of Population-Based Cancer Research
  • Karolinska Institutet
  • Aarhus University
  • Danish Cancer Society Research Center
  • University of Rennes I
  • German Cancer Research Centre
  • German Institute of Human Nutrition
  • Hellenic Health Foundation, Athens
  • National and Kapodistrian University of Athens
  • Cancer Research and Prevention Institute (ISPO)
  • Istituto Nazionale dei Tumori
  • University of Naples Federico II
  • Civic and M.P Arezzo Hospital
  • Citta' della Salute e della Scienza Hospital-University of Turin
  • Azienda Sanitaria Locale Torino 3
  • Norwegian Institute of Public Health
  • Public Health Directorate
  • Instituto de Investigación Biosanitaria de Granada (Granada.ibs)
  • CIBER Epidemiology and Public Health (CIBERESP)
  • Murcia Regional Health Council
  • University of Murcia
  • Health Research Institute of Navarra (IDISNA)
  • Public Health Division of Gipuzkoa
  • Skåne University Hospital
  • Umeå University
  • National Institute for Public Health and the Environment (RIVM)
  • University Medical Center Utrecht
  • University of Cambridge
  • University of Oxford
  • Norwegian University of Science and Technology
  • Bjørknes University College
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology


  • EPIC, fruit juices, fruits, intake, thyroid cancer, vegetables
Original languageEnglish
Pages (from-to)449-459
Number of pages11
JournalInternational Journal of Cancer
Issue number3
Publication statusPublished - 2018 Feb 1
Publication categoryResearch