Fruit and total cancer.

Total cancer risk:
21 articles, providing information about 16 different cohorts were found (The EPIC Cohort was counted as 1 cohort, though data from 3 different populations was available). The sum of these cohorts provided information about a total of 70,802 incident cancer cases.
Associations are stratified by sex:

Men: Data for men was provided by 8 cohort, including a total of > 40,621 cases.
A significant protective effect was only found in the smallest cohort, including 138 cases (15). No other associations were found, but RRs were ≤ 1.
Women: Data for women was provided by 6 cohorts, including a total of > 25,471 cases.
A significant protective effect was found in one small cohort, including 690 cases (2). A nonsignificant trend of a protective effect was found in one other cohort, including 131 cases (10). And a nonsignicant trend of a protective effect was found in another cohort, but the strength of the association is extremely weak: a 1% decreased risk (22).

Inclusion of intermediate levels of consumption:
Significant protective effects at any level of consumption were as follows: Among men > 200 g/day (Jansen MC), among women > 192 g/day (Shibata A), and 335 g/day (Benetou V), and among men & women combined ≥ 12.6 g/day (Maynard M). No (non)significantly increased risk at any level of consumption was found in any cohort.

RRs for the association between total fruits and total cancer risk (g/day):



Conclusion: Hardly any association was found among men, and inconsistent findings were done among women. Though some nonsignificant trends of a protective effect were found among women, the power of the effect was very weak, and the weight of the evidence does not justify the label of a possible association. No evidence was found for an association of total fruit with total cancer risk.
Total cancer mortality:
11 articles, providing information about 10 different cohorts were found including a total of > 4,938 cases (no data was available from 2 cohorts: Hung HC; 2004).
Significant protective effects were found in 2 cohorts, including 3,816 cases (4, 14), though in one cohort the association was significant for men only (4). No other associations were found.

Conclusion: Significant protective effects were found in 2 cohorts. Within one cohort, an effect was found for daily vs less frequent consumption (4), and in the other one for (almost) daily consumption vs < 2 servings/wk (14), indicating that a protective effect may only be found compared with very low or infrequent consumption. Since no data about the amount of cancer cases was available from 2 cohorts, evidence was judged suggestive for a protective effect of total fruits against total cancer mortality for daily vs less frequent consumption.