Fruit and Vegetable Intake in Relation to the Risks of Lung, Colorectal, Stomach, and Overall Cancers in China: A Prospective Cohort Study

Although previous cohort studies have examined the association between vegetable and fruit intake and cancer risk, the findings remain inconsistent. Using data from 50,987 participants in the Shanghai Suburban Adult Cohort and Biobank (2016 to 2019), we investigated the relationship between vegetable and fruit intake and the incidence of cancers through linkage with the cancer registry up to June 30, 2024. Participants in the highest quartile of total vegetable and fruit intake had a lower risk of overall cancer (HR: 0.81, 95% CI: 0.72-0.90), with similar inverse associations observed for vegetables and fruits separately. Higher intake was also associated with lower risks of lung and stomach cancers, whereas no associations were observed for colorectal cancer. In continuous analyses, each SD increase in total vegetable and fruit intake was associated with a lower risk of overall cancer (HR: 0.92, 95% CI: 0.88-0.97), and the findings were generally consistent with those from quartile-based analyses. In subgroup analyses, these inverse associations were observed among participants with favorable lifestyles and health conditions. RCS analyses identified nonlinear associations between fruit intake and the risks of overall and lung cancer, with the protective associations becoming less pronounced at excessive intake levels.