Abstract 845: Association of nut consumption with risk of total and specific cancers: Evidence from three large prospective cohort studies
Authors: Fang Zhe , Wu You , Li Yanping , Zhang Xuehong , Willett Walter , Eliassen A. Heather , Rosner Bernard , Song Mingyang , Mucci Lorelei , Giovannucci Edward 
Published: July 2021

Abstract
Background The associations between nut consumption, especially specific types of nuts, and cancer risk have not been extensively investigated.
Methods Nut consumption and other risk factors were assessed at baseline and updated every 2 to 4 years in the Nurses' Health Study (1980 to 2014), the Nurses' Health Study II (1991 to 2015), and the Health Professionals Follow-up Study (1986 to 2018). We examined the associations between the intake of total and specific types of nuts and the risk of total cancer, as well as common cancers with a high incidence including cancers of lung, colorectum, breast, bladder, and aggressive prostate cancer among participants who were free of cancer, heart disease, and stroke at baseline. Cox proportional hazards models were used to obtain the hazard ratios (HRs) and 95% confidence intervals (95% CIs) in each cohort separately as well as pooled. To check the robustness of simply pooled HRs, we pooled the HRs in each cohort with meta-analysis using both random-effect model and fixed-effect model. We also added a 12-year lag period between nut-intake assessment and each follow-up period.
Results During a median of 26.8 years of follow-up (1,015,834 person-years) in HPFS, 35.4 years (2,575,205 person-years) in NHS, 26.0 years (2,282,632 person-years) in NHSII, we documented 44,561 incidence cancer cases, including 3,972 lung cancer, 4,184 colorectal cancer, 1,588 bladder cancer, 10,936 breast cancer, and 1,171 aggressive prostate cancer cases. As compared to non-consumers, the pooled multivariable HRs of total nut consumption for five or more servings/week were 0.99 (95% CI: 0.94 to 1.04, P trend = 0.52) for total cancer, 0.88 (95% CI: 0.74 to 1.03, P trend = 0.16) for lung cancer, 1.08 (95% CI: 0.92 to 1.26, P trend = 0.87) for colorectal cancer, 0.90 (95% CI: 0.71 to 1.14, P trend = 0.64) for bladder cancer, 0.96 (95% CI: 0.85 to 1.08, P trend = 0.34) for breast cancer and 1.18 (95% CI: 0.92 to 1.51, P trend = 0.52) for aggressive prostate cancer. The associations between specific types of nuts and risk of total and specific cancers were also null. In the latency analysis, we did not observe any significant associations between nut consumption and 12-year latent risk of cancer in the pooled data.
Conclusions In three large prospective cohorts of health professionals, frequent nut consumption was not associated with risk of total cancer and major individual cancers after adjustment for known or suspected risk factors.
Citation Format: Zhe Fang, You Wu, Yanping Li, Xuehong Zhang, Walter Willett, A. Heather Eliassen, Bernard Rosner, Mingyang Song, Lorelei Mucci, Edward Giovannucci. Association of nut consumption with risk of total and specific cancers: Evidence from three large prospective cohort studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 845.