Dietary consumption and diet diversity and risk of developing bladder cancer: Results from the South East China case-control study


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Fatima Isa1, Li-Ping Xie2, Zhiquan Hu3, Zhaohui Zhong4, Marjolein Hemelt1, Raoul C Reulen1,8, YC Wong5, Po-Chor Tam6, Kai Yang2, Chao Chai7, Xing Zeng3, Yilan Deng4, Wei-De Zhong7, Maurice Zeegers1,8
1Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK, 2Department of Urology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China, 3Department of Urology, Tongji Hospital, Tongji Medical University, Wuhan, China, 4Department of Urology,The Second Xiangya Hospital of Central South University, Changsha, China, 5Department of Anatomy, Faculty of Medicine, The University of Hong Kong, Hong Kong, China, 6Department of Surgery, The University of Hong Kong, Hong Kong, China, 7Department of Urology, The 1st Municipal Hospital of Guangzhou, Guangzhou Medical College, Guangzhou, China, 8Department of Complex Genetics, Cluster of Genetics and Cell Biology, Nutrition and Toxicology Research Institute, Maastricht University Hospital, Maastricht, The Netherlands


The epidemiologic evidence on the role of dietary consumption on the risk of bladder cancer in the Chinese population is limited. We investigated the role of dietary consumption and diet diversity on the risk of developing bladder cancer within a Chinese population.


A hospital-based, case-control study of 487 cases and 469 controls was conducted in four public hospitals in South and East China. Trained interviewers used a food frequency questionnaire to gather information on the consumption of 35 specific food items.


The OR of developing bladder cancer increased significantly with increasing consumption of red meat (Ptrend=0.01) and organ meat (Ptrend<0.01). The consumption of white fish was significantly associated with a decreased OR (Ptrend<0.001). Significant inverse associations for consumption of citrus fruits (Ptrend=0.007), stone fruits (Ptrend<0.001) and vine fruits (Ptrend=0.015) were observed. The OR decreased significantly with increasing consumption of flower vegetables (Ptrend<0.001) and potatoes (Ptrend=0.005). The OR increased significantly with increasing consumption of leafy vegetables (Ptrend=0.003), bulb vegetables (Ptrend=0.003) and preserved vegetables (Ptrend=0.007). An inverse significant association was observed between increasing consumption of dairy products and bladder cancer (Ptrend<0.001). The OR decreased significantly with increasing total diet diversity (Ptrend=0.021) and fruit diversity (Ptrend<0.001).


This is one of the first studies to examine the relationship between diet diversity and bladder cancer in detail in the Chinese population. Our results indicate that a diet rich in various food items may have a beneficial effect on bladder cancer. These findings support dietary guidelines that recommend a more varied diet. It also adds to the growing body of epidemiologic evidence on diet and bladder cancer risk in a non-Caucasian population.