Journal article

Grain and dietary fiber intake and bladder cancer risk: a pooled analysis of prospective cohort studies

Evan YW Yu, Anke Wesselius, Siamak Mehrkanoon, Maree Brinkman, Piet van den Brandt, Emily White, Elisabete Weiderpass, Florence Le Calvez-Kelm, Marc Gunter, Inge Huybrechts, Fredrik Liedberg, Guri Skeie, Anne Tjonneland, Elio Riboli, Graham G Giles, Roger L Milne, Maurice P Zeegers



BACKGROUND: Higher intakes of whole grains and dietary fiber have been associated with lower risk of insulin resistance, hyperinsulinemia, and inflammation, which are known predisposing factors for cancer. OBJECTIVES: Because the evidence of association with bladder cancer (BC) is limited, we aimed to assess associations with BC risk for intakes of whole grains, refined grains, and dietary fiber. METHODS: We pooled individual data from 574,726 participants in 13 cohort studies, 3214 of whom developed incident BC. HRs, with corresponding 95% CIs, were estimated using Cox regression models stratified on cohort. Dose-response relations were examined using fractional polynomial regression models..

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Awarded by World Cancer Research Fund International grant

Awarded by European Commission grant

Awarded by China Scholarship Council

Awarded by DOE

Awarded by RERF Research Protocol

Awarded by National Cancer Institute

Awarded by Australian National Health and Medical Research Council

Funding Acknowledgements

Supported in part by World Cancer Research Fund International grant WCRF 2012/590 (to MPZ) and European Commission grant FP7-PEOPLE-618308 (to MPZ). EYWY was supported by China Scholarship Council award no. 201706310135. The Netherlands Cohort Study on diet and cancer was supported by the Dutch Cancer Society. The RERF Atomic Bomb Survivors Study was supported by The Radiation Effects Research Foundation (RERF), Hiroshima and Nagasaki, Japan, a public interest foundation funded by the Japanese Ministry of Health, Labour and Welfare and the US Department of Energy (DOE). The research was also funded in part through DOE award DE-HS0000031 to the National Academy of Sciences. This publication was supported by RERF Research Protocol RP-A5-12. VITAL (VITamins and Lifestyle cohort study) was supported by National Cancer Institute grant R01CA74846. EPIC (The European Prospective Investigation into Cancer and Nutrition) was carried out with the financial support of the "Europe Against Cancer" Programme of the European Commission (SANCO); Ligue contre le Cancer (France); Societe 3 M (France); Mutuelle Generale de l'Education Nationale; Institut National de la Sante et de la Recherche Medicale; Institute Gustave Roussy; German Cancer Aid; German Cancer Research Centre; German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health; the Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia, and Navarra; Cancer Research UK; Medical Research Council, UK; Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; Wellcome Trust, UK; Greek Ministry of Health; Greek Ministry of Education; Italian Association for Research on Cancer; Italian National Research Council; Dutch Ministry of Public Health, Welfare and Sports; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund; Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; Norwegian Cancer Society; and Norwegian Research Council. Partial support for the publication of this supplement was provided by the Centre de Recherche et d'Information Nutritionnelles. Melbourne Collaborative Cohort Study (MCCS) cohort recruitment was funded by Cancer Council Victoria (ht tp:// and VicHealth ( MCCS was further augmented by Australian National Health and Medical Research Council grants 209057, 396414 and 1074383 and by infrastructure provided by Cancer Council Victoria. Cases and their vital status were ascertained through the Victorian Cancer Registry and the Australian Institute of Health and Welfare, including the National Death Index and the Australian Cancer Database.