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Annals of Oncology Advance Access published online on August 9, 2005
Annals of Oncology, doi:10.1093/annonc/mdi361
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© 2005 European Society for Medical Oncology
Received March 21, 2005
Revised May 5, 2005
Accepted June 28, 2005

Original article

Does an apple a day keep the oncologist away?

S. Gallus 1*, R. Talamini 2, A. Giacosa 3, M. Montella 4, V. Ramazzotti 5, S. Franceschi 6, E. Negri 1, and C. La Vecchia 7

1 Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milan
2 Servizio di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, 33081 Aviano
3 Gastroenterology and Nutrient Unit, National Institute for Cancer Research, Genoa
4 Servizio di Epidemiologia e Prevenzione, Istituto Tumori Fondazione Pascale, Naples
5 Servizio Integrato di Epidemiologia e Sistemi Informativi, Istituto Nazionale Tumori "Regina Elena", Rome
6 Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, 20133 Milan, Italy
7 Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milan; Infection and Cancer Epidemiology Group, International Agency for Research on Cancer, Lyon, France

* To whom correspondence should be addressed.
S. Gallus, E-mail: gallus{at}marionegri.it


  Abstract

Background: Apples have commonly been described as a healthy food. To understand better their role on risk of cancer at several sites, we analyzed data from multicenter case-control studies conducted between 1991 and 2002 in Italy.

Patients and methods: The studies included 598 patients with incident cancers of the oral cavity and pharynx, 304 of the oesophagus, 460 of the larynx, 1953 of the colorectum, 2569 of the breast, 1031 of the ovary and 1294 of the prostate. The comparison group included a total of 6629 patients admitted to the same network of hospitals as cases for acute, non-neoplastic diseases. Multivariate odds ratios (OR) were obtained with allowance for age, sex, study center, education, body mass index, tobacco smoking, alcohol drinking, total energy intake, vegetable consumption and physical activity.

Results: Compared with subjects reporting consumption of <1 apple/day, the ORs for ≥1 apple/day were 0.79 [95% confidence interval (CI) 0.62-1.00] for cancers of the oral cavity and pharynx, 0.75 (95% CI 0.54-1.03) for oesophagus, 0.80 (95% CI 0.71-0.90) for colorectum, 0.58 (95% CI 0.44-0.76) for larynx, 0.82 (95% CI 0.73-0.92) for breast, 0.85 (95% CI 0.72-1.00) for ovary and 0.91 (95% CI 0.77-1.07) for prostate.

Conclusion: This investigation found a consistent inverse association between apples and risk of various cancers.

Keywords: cancer; case-control study; diet; fruit; risk factor.
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