Fruit and Vegetable Intake in Relation to Lung Cancer Risk: A Systematic Review and Dose-response Meta-analysis of Prospective Cohort Studies.

The objective of this study was to consolidate the mounting evidence related to the association between fruit and vegetable intake and lung cancer risk by conducting a systematic review of prospective studies and a dose-response meta-analysis. A systematic search was conducted on major online databases (PubMed, Scopus, and Web of Science) from inception up to January 2024. The exposures included daily intake of total fruits and vegetables (FVs), vegetables, fruits, and their subclasses (including cruciferous and green leafy vegetables, and citrus fruits). The main outcome was lung cancer and its subclasses (incidence and mortality). Out of 31,819 records initially retrieved, 41 eligible studies were included. Significant inverse associations were observed between lung cancer and daily consumption of total FVs (risk ratios [RR]: 0.81, 95% CI: 0.74-0.90), vegetables (RR: 0.87, 95% CI: 0.83-0.91), fruits (RR: 0.78, 95% CI: 0.72-0.85), cruciferous vegetables (RR: 0.82, 95% CI: 0.75-0.91), green leafy vegetables (RR: 0.85, 95% CI: 0.76-0.94), and citrus fruits (RR: 0.80, 95% CI: 0.73-0.88). Non-linear dose-response associations were observed regarding lung cancer and all of the exposures, except for cruciferous vegetables. The consumption of FVs may decrease the risk of lung cancer incidence and mortality. The type of lung cancer, biological sex of individuals, and smoking status can alter this association.