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An inverse association between the Mediterranean diet and bladder cancer risk: a pooled analysis of 13 cohort studies

Witlox WJA 1 , van Osch FHM 1 , Brinkman M 1 , Jochems S 1 , Goossens ME 2 , Weiderpass E 3 Show all authors , White E 4 , van den Brandt PA 5 , Giles GG 6 , Milne RL 6 , Huybrechts I 7 , Adami HO 3 , Bueno-de-Mesquita B 8 , Wesselius A 9 , Zeegers MP 1

Affiliations 

  • 1 Department of Complex Genetics and Epidemiology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, 6200 MD, Maastricht, The Netherlands
  • 2 Department of General Practice, Katholieke Universiteit Leuven, ACHG-KU Leuven, Kapucijnenvoer 33, Blok J, bus 7001, 3000, Leuven, Belgium
  • 3 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  • 4 Fred Hutchinson Cancer Research Center, Seattle, WA, USA
  • 5 Department of Epidemiology, Schools for Oncology and Developmental Biology and Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
  • 6 Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
  • 7 International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
  • 8 Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), BA Bilthoven, The Netherlands
  • 9 Department of Complex Genetics and Epidemiology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40, 6200 MD, Maastricht, The Netherlands. anke.wesselius@maastrichtuniversity.nl
Eur J Nutr, 2020 Feb;59(1):287-296.
PMID: 30737562 DOI: 10.1007/s00394-019-01907-8

Abstract

PURPOSE: The role of diet in bladder carcinogenesis has yet to be established. To date most studies have investigated dietary components individually, rather than as dietary patterns, which may provide stronger evidence for any influence of diet on bladder carcinogenesis. The Mediterranean diet has been associated with many health benefits, but few studies have investigated its association with bladder cancer risk.

METHODS: We investigated the potential association between the Mediterranean diet score (MDS) and risk of developing bladder cancer by pooling 13 prospective cohort studies included in the BLadder cancer Epidemiology and Nutritional Determinants (BLEND) study and applying a Cox regression analysis.

RESULTS: Dietary data from 646,222 study participants, including 3639 incident bladder cancer cases, were analysed. We observed an inverse association between Mediterranean diet and bladder cancer risk (HRhigh 0.85 [95% CI 0.77, 0.93]). When stratifying the results on non-muscle-invasive or muscle-invasive disease or sex the association remained similar and the HR estimate was consistently below 1.00 both for medium and high adherence to the Mediterranean diet. A consistent association was observed when disregarding fat or alcohol intake.

CONCLUSION: We found evidence that adherence to the Mediterranean diet was associated with reduced risk of developing bladder cancer, suggesting a positive effect of the diet as a whole and not just one component.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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