Cruciferous Vegetables Intake Is Associated with Lower Risk of Renal Cell Carcinoma: Evidence from a Meta-Analysis of Observational Studies

<div><p>Background</p><p>Epidemiologic studies have evaluated the association between cruciferous vegetables(CV) intake and the risk of renal cell carcinoma(RCC); however, the existing results are controversial. The aim of this meta-analysis was to investigate the association between CV intake and RCC risk.</p><p>Methods</p><p>A literature search was carried out using PUBMED and EMBASE database between January 1966 and March 2013. Fixed-effect and random-effect models were used to estimate summary relative risks (RR) and the corresponding 95% confidence intervals (CIs). Potential sources of heterogeneity were detected by meta-regression. Subgroup analyses, sensitivity analysis and cumulative meta-analysis were also performed.</p><p>Results</p><p>A total of 12 studies (six cohorts, six case–control) contributed to the analysis, involving 1,228,518 participants and 5,773 RCC cases. When all studies were pooled, we observed a significantly inverse association between CV intake and RCC risk (RR = 0.81, 95% CI [0.72, 0.91]). This association was also significant when analyses were restricted to six high-quality studies (RR = 0.89, 95% CI [0.82, 0.98]). In subgroup analyses, CV intake was significantly associated with reduced RCC risk among studies conducted in America (RR = 0.77, 95%CI [0.70, 0.86]); however, CV intake had no significant association with RCC risk among studies conducted in Europe (RR = 0.87, 95%CI [0.71, 1.07]). Furthermore, sensitivity analysis confirmed the stability of results.</p><p>Conclusions</p><p>The findings of this meta-analysis suggested that high intake of CV was inversely associated with RCC risk among Americans. More studies, especially high quality cohort studies with larger sample size, well controlled confounding factors are warranted to confirm this association.</p></div

Funnel plot for publication bias in the studies investigating risk for RCC associated with CV intake.

<p>Funnel plot for publication bias in the studies investigating risk for RCC associated with CV intake.</p

Forest plot: cumulative meta-analysis of CV intake and RCC risk.

<p>Forest plot: cumulative meta-analysis of CV intake and RCC risk.</p

Flow diagram of screened, excluded, and analysed publications.

<p>Flow diagram of screened, excluded, and analysed publications.</p

Forest plot: overall meta-analysis of CV intake and RCC risk.

<p>Squares indicated study-specific risk estimates (size of square reflects the study-statistical weight, i.e. inverse of variance); horizontal lines indicate 95% confidence intervals; diamond indicates summary relative risk estimate with its corresponding 95% confidence interval.</p

Methodologic quality of cohort studies included in the meta-analysis.

1<p>A cohort study with a follow-up time >8 y was assigned one star.</p>2<p>A cohort study with a follow-up rate >75% was assigned one star.</p

Study characteristics of published cohort and case-control studies on cruciferous vegetables intake and risk of renal cell carcinoma.

<p>Study characteristics of published cohort and case-control studies on cruciferous vegetables intake and risk of renal cell carcinoma.</p

Methodological quality of case-control studies included in the meta-analysis.

1<p>One star was assigned if there was no significant difference in the response rate between control subjects and cases by using the chi-square test (P>0.05).</p

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