Total cancer risk: Data about total cancer risk was provided by 3 cohorts. No associations were found with citrus fruit juices in 2 cohorts (11), or with orange juice or apple juice in another cohort (20).
Effect modification: Data about effect modification was provided by a pooled analysis of 2 cohorts including 9,084 cases (11). A significantly increased cancer risk of citrus fruit juice was found among users of multivitamins, but no association was found among non-users of multivitamins. Risk was presented for an increase of 1 serving/day.
Total cancer mortality: Data about total cancer mortality was provided by 1 cohort (21). No association was found with fresh fruit juice in summer season among both men and women.

Conclusion: A significantly increased cancer risk of citrus fruit juice among multivitamin supplement users was found in a pooled analysis of 2 cohorts. No other associations were found. Citrus fruit juice possibly increases total cancer risk among multivitamin supplement users. No level of consumption could be defined for this effect.