Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Epidemiology

Cruciferous vegetables and colorectal cancer risk: a hospital-based matched case–control study in Northeast China

Abstract

Background/objectives

Conflicting results have been reported on the association of cruciferous vegetable intake and colorectal cancer risk. This study aimed to clarify the relationship of cruciferous vegetables and colorectal cancer among individuals in Northeast China, where large amounts of cruciferous vegetables are consumed habitually.

Subjects/methods

We conducted a hospital-based case–control study in the First Hospital of China Medical University, the Shengjing Hospital of China Medical University and the First Hospital of Dalian Medical University from 2009 to 2011. Patients in the study were matched individually by age, gender, and city of residence. The study ultimately included 833 case–control pairs. A structured questionnaire was applied to collect data on general characteristics, dietary habits, and selected dietary intake. Differences between cases and controls were ascertained with the chi-square test or the Mann–Whitney U test. Unconditional logistic regression was employed to compute odds ratios (ORs) and 95% confidence intervals (CIs). Stratified analyses were conducted by gender.

Results

In the total study cohort, no significant association was found between total cruciferous vegetable intake and colorectal cancer risk. The adjusted OR for the highest versus the lowest intake was 0.83 (95% CI: 0.59–1.18). In stratification analyses by gender, reduced colorectal cancer risk was related to higher consumption of total cruciferous vegetables in women but not in men. Significant inverse correlations were found in analyses of individual cruciferous vegetables, including greens (OR = 0.47; 95% CI: 0.32–0.68), cabbage (OR = 0.61; 95% CI: 0.44–0.86), and cauliflower (OR = 0.66; 95% CI: 0.48–0.92).

Conclusions

No significant association was found between total cruciferous vegetable intake and colorectal cancer risk. However, specific types of cruciferous vegetables might have protective roles against colorectal cancer.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet. 2014;383:1490–502.

    Article  Google Scholar 

  2. WCRF/AICR: Colorectal Cancer Report. Food, nutrition, physical activity and theprevention of colorectal cancer 2011. This report provides the recent evidenceon colorectal cancer from the Continuous Update Project.

  3. Zitvogel L, Pietrocola F, Kroemer G. Nutrition, inflammation and cancer. Nat Immunol. 2017;18:843–50.

    Article  CAS  Google Scholar 

  4. Lam TK, Ruczinski I, Helzlsouer KJ, Shugart YY, Caulfield LE, Alberg AJ. Cruciferous vegetable intake and lung cancer risk: a nested case–control study matched on cigarette smoking. Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive. Oncology. 2010;19:2534–40.

    CAS  Google Scholar 

  5. Moore LE, Brennan P, Karami S, Hung RJ, Hsu C, Boffetta P, et al. Glutathione S-transferase polymorphisms, cruciferous vegetable intake and cancer risk in the Central and Eastern European Kidney Cancer Study. Carcinogenesis. 2007;28:1960–4.

    Article  CAS  Google Scholar 

  6. Tang L, Zirpoli GR, Guru K, Moysich KB, Zhang Y, Ambrosone CB, et al. Consumption of raw cruciferous vegetables is inversely associated with bladder cancer risk. Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive. Oncology. 2008;17:938–44.

    CAS  Google Scholar 

  7. Tang L, Zirpoli GR, Jayaprakash V, Reid ME, McCann SE, Nwogu CE, et al. Cruciferous vegetable intake is inversely associated with lung cancer risk among smokers: a case–control study. BMC Cancer. 2010;10:162.

    Article  Google Scholar 

  8. Hara M, Hanaoka T, Kobayashi M, Otani T, Adachi HY, Montani A, et al. Cruciferous vegetables, mushrooms, and gastrointestinal cancer risks in a multicenter, hospital-based case–control study in Japan. Nutr Cancer. 2003;46:138–47.

    Article  Google Scholar 

  9. Voorrips LE, Goldbohm RA, van Poppel G, Sturmans F, Hermus RJ, van den Brandt PA. Vegetable and fruit consumption and risks of colon and rectal cancer in a prospective cohort study: the Netherlands Cohort Study on Diet and Cancer. Am J Epidemiol. 2000;152:1081–92.

    Article  CAS  Google Scholar 

  10. Hu J, Morrison H, Mery L, DesMeules M, Macleod M. Diet and vitamin or mineral supplementation and risk of colon cancer by subsite in Canada. Eur J Cancer Prev 2007;16:275–91.

    Article  CAS  Google Scholar 

  11. Park Y, Subar AF, Kipnis V, Thompson FE, Mouw T, Hollenbeck A, et al. Fruit and vegetable intakes and risk of colorectal cancer in the NIH-AARP diet and health study. Am J Epidemiol. 2007;166:170–80.

    Article  Google Scholar 

  12. Wu QJ, Yang Y, Vogtmann E, Wang J, Han LH, Li HL, et al. Cruciferous vegetables intake and the risk of colorectal cancer: a meta-analysis of observational studies. Ann Oncol. 2013;24:1079–87.

    Article  CAS  Google Scholar 

  13. Moy KA, Yuan JM, Chung FL, Van Den Berg D, Wang R, Gao YT, et al. Urinary total isothiocyanates and colorectal cancer: a prospective study of men in Shanghai, China. Cancer Epidemiol Biomark Prev. 2008;17:1354–9.

    Article  CAS  Google Scholar 

  14. Tse G, Eslick GD. Cruciferous vegetables and risk of colorectal neoplasms: a systematic review and meta-analysis. Nutr Cancer. 2014;66:128–39.

    Article  CAS  Google Scholar 

  15. Chiu BC, Ji BT, Dai Q, Gridley G, McLaughlin JK, Gao YT, et al. Dietary factors and risk of colon cancer in Shanghai, China. Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive. Oncology. 2003;12:201–8.

    Google Scholar 

  16. Yang G, Gao YT, Shu XO, Cai Q, Li GL, Li HL, et al. Isothiocyanate exposure, glutathione S-transferase polymorphisms, and colorectal cancer risk. Am J Clin Nutr. 2009;91:704–11.

    Article  Google Scholar 

  17. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66:115–32.

    Article  Google Scholar 

  18. Higdon JV, Delage B, Williams DE, Dashwood RH. Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res. 2007;55:224–36.

    Article  CAS  Google Scholar 

  19. Holst B, Williamson G. A critical review of the bioavailability of glucosinolates and related compounds. Nat Prod Rep. 2004;21:425–47.

    Article  CAS  Google Scholar 

  20. Liu RH. Potential synergy of phytochemicals in cancer prevention: mechanism of action. J Nutr. 2004;134(12 Suppl):3479s–85s.

    Article  CAS  Google Scholar 

  21. Smith TK, Mithen R, Johnson IT. Effects of Brassica vegetable juice on the induction of apoptosis and aberrant crypt foci in rat colonic mucosal crypts in vivo. Carcinogenesis. 2003;24:491–5.

    Article  CAS  Google Scholar 

  22. Smith TK, Lund EK, Clarke RG, Bennett RN, Johnson IT. Effects of Brussels sprout juice on the cell cycle and adhesion of human colorectal carcinoma cells (HT29) in vitro. J Agric Food Chem. 2005;53:3895–901.

    Article  CAS  Google Scholar 

  23. Steinkellner HRS, Freywald C. Effects of cruciferous vegetables and their constituents on drug metabolizing enzymes involved in the bioactivation of DNA-reactive dietary carcinogens. Mutat Res. 2001;480-481:285–97.

    Article  CAS  Google Scholar 

  24. Auborn KJFS, Rosen EM, Goodwin L, Chandraskaren A, Williams DE, et al. Indole-3-carbinol is a negative regulator of estrogen. J Nutr. 2003;133(7 Suppl):2470S–5S.

    Article  CAS  Google Scholar 

  25. Sundar SNKV, Equinozio CN, Doan VB, Bjeldanes LF, Firestone GL. Indole-3-carbinol selectively uncouples expression and activity of estrogen receptor subtypes in human breast cancer cells. Mol Endocrinol. 2006;20:3070–82.

    Article  CAS  Google Scholar 

  26. Benninghoff AD, Williams DE. The role of estrogen receptor beta in transplacental cancer prevention by indole-3-carbinol. Cancer Prev Res. 2013;6:339–48.

    Article  CAS  Google Scholar 

  27. Mahfouz EM, Sadek RR, Abdel-Latief WM, Mosallem FA, Hassan EE. The role of dietary and lifestyle factors in the development of colorectal cancer: case control study in Minia, Egypt. Cent Eur J Public Health. 2014;22:215–22.

    Article  Google Scholar 

  28. Tan W, Lin D, Xiao Y. Chemoprevention of 2-amino-1-methyl-6-phenylimidazo[4,5-b] pyridine-induced carcinogen-DNA adducts by Chinese cabbage in rats. Chin J Oncol. 1998;20:408–11.

    CAS  Google Scholar 

  29. Nomura AM, Wilkens LR, Murphy SP, Hankin JH, Henderson BE, Pike MC, et al. Association of vegetable, fruit, and grain intakes with colorectal cancer: the Multiethnic Cohort Study. Am J Clin Nutr. 2008;88:730–7.

    Article  CAS  Google Scholar 

  30. Azeem S, Gillani SW, Siddiqui A, Jandrajupalli SB, Poh V, Syed Sulaiman SA. Diet and colorectal cancer risk in Asia—a systematic review. Asian Pac J Cancer Prev. 2015;16:5389–96.

    Article  Google Scholar 

  31. McCullough ML, Robertson AS, Chao A, Jacobs EJ, Stampfer MJ, Jacobs DR, et al. A prospective study of whole grains, fruits, vegetables and colon cancer risk. Cancer Causes Control. 2003;14:959–70.

    Article  Google Scholar 

  32. Vogtmann E, Xiang YB, Li HL, Cai Q, Wu QJ, Xie L, et al. Cruciferous vegetables, glutathione S-transferase polymorphisms, and the risk of colorectal cancer among Chinese men. Ann Epidemiol. 2014;24:44–9.

    Article  Google Scholar 

  33. Pietinen P, Malila N, Virtanen M, Hartman TJ, Tangrea JA, Albanes D, et al. Diet and risk of colorectal cancer in a cohort of Finnish men. Cancer Causes Control. 1999;10:387–96.

    Article  CAS  Google Scholar 

  34. Hsing AW, McLaughlin JK, Chow WH, Schuman LM, Co Chien HT, Gridley G, et al. Risk factors for colorectal cancer in a prospective study among U.S. white men. Int J Cancer. 1998;77:549–53.

    Article  CAS  Google Scholar 

  35. Zhang Y. Cancer-preventive isothiocyanates: measurement of human exposure and mechanism of action. Mutat Res. 2004;555:173–90.

    Article  CAS  Google Scholar 

  36. Zhang M, Yang ZY, Bins CW, Lee AH. Diet and ovarian cancer risk: a case–control study in China. Br J Cancer. 2002;86:712–7.

    Article  CAS  Google Scholar 

  37. Zhang M, Zhao X, Zhang X, Holman CD. Possible protective effect of green tea intake on risk of adult leukaemia. Br J Cancer. 2008;98:168–70.

    Article  CAS  Google Scholar 

  38. Zhang M, Holman CD. Low-to-moderate alcohol intake and breast cancer risk in Chinese women. Br J Cancer. 2011;105:1089–95.

    Article  CAS  Google Scholar 

  39. Tong JH, Li Z, Shi J, Li HM, Wang Y, Fu LY, et al. Passive smoking exposure from partners as a risk factor for ER+/PR+double positive breast cancer in never-smoking Chinese urban women: a hospital-based matched case control study. PLoS ONE. 2014;9:e97498.

    Article  Google Scholar 

  40. Xu X, Byles JE, Shi Z, Hall JJ. Evaluation of older Chinese people’s macronutrient intake status: results from the China Health and Nutrition Survey. Br J Nutr. 2015;113:159–71.

    Article  CAS  Google Scholar 

  41. Bian S, Gao Y, Zhang M, Wang X, Liu W, Zhang D, et al. Dietary nutrient intake and metabolic syndrome risk in Chinese adults: a case–control study. Nutr J. 2013;12:106.

    Article  CAS  Google Scholar 

  42. Zou Y, Zhang R, Xia S, Huang L, Meng J, Fang Y, et al. Dietary patterns and obesity among Chinese adults: results from a household-based cross-sectional study. Int J Environ Res Public Health. 2017;14.

Download references

Acknowledgements

The authors thank all participants of this study.

Funding

The National Key Research and Development Program of China (No. 2017YFC1308900), Project for clinical ability construction of Chinese medicine, Science and Technology Plan Project of Liaoning Province (2016007010) (Yunpeng Liu) National Science and Technology Major Project of the Ministry of Science and Technology of China (No. 2017ZX09304025), Distinguished professor of Liaoning Province (Xiujuan Qu).

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Yunpeng Liu or Zhi Li.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

41430_2018_341_MOESM1_ESM.docx

S1 Table. Odds ratios(ORs) and 95% confidence intervals(CIs) for the association of yearly pickled Chinese cabbage intake and mustard intake with colorectal cancer risk

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fang, W., Qu, X., Shi, J. et al. Cruciferous vegetables and colorectal cancer risk: a hospital-based matched case–control study in Northeast China. Eur J Clin Nutr 73, 450–457 (2019). https://doi.org/10.1038/s41430-018-0341-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-018-0341-5

Search

Quick links