***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Recently , there has been interest in whether intakes of specific types of fat are associated with breast cancer risk independently of other types of fat , but results have been inconsistent . We identified 8 prospect i ve studies that met predefined criteria and analyzed their primary data using a st and ardized approach . Holding total energy intake constant , we calculated relative risks for increments of 5 % of energy for each type of fat compared with an equivalent amount of energy from carbohydrates or from other types of fat . We combined study -specific relative risks using a r and om effects model . In the pooled data base , 7,329 incident invasive breast cancer cases occurred among 351,821 women . The pooled relative risks ( 95 % confidence intervals [ CI ] ) for an increment of 5 % of energy were 1.09 ( 1.00 - 1.19 ) for saturated , 0.93 ( 0.84 - 1.03 ) for monounsaturated and 1.05 ( 0.96 - 1.16 ) for polyunsaturated fat compared with equivalent energy intake from carbohydrates . For a 5 % of energy increment , the relative risks were 1.18 ( 95 % CI 0.99 - 1.42 ) for substituting saturated for monounsaturated fat , 0.98 ( 95 % CI 0.85 - 1.12 ) for substituting saturated for polyunsaturated fat and 0.87 ( 95 % CI 0.73 - 1.02 ) for substituting monounsaturated for polyunsaturated fat . No associations were observed for animal or vegetable fat intakes . These associations were not modified by menopausal status . These data are suggestive of only a weak positive association with substitution of saturated fat for carbohydrate consumption ; none of the other types of fat examined was significantly associated with breast cancer risk relative to an equivalent reduction in carbohydrate consumption BACKGROUND We tested the hypothesis that dietary intervention can inhibit the development of recurrent colorectal adenomas , which are precursors of most large-bowel cancers . METHODS We r and omly assigned 2079 men and women who were 35 years of age or older and who had had one or more histologically confirmed colorectal adenomas removed within six months before r and omization to one of two groups : an intervention group given intensive counseling and assigned to follow a diet that was low in fat ( 20 percent of total calories ) and high in fiber ( 18 g of dietary fiber per 1000 kcal ) and fruits and vegetables ( 3.5 servings per 1000 kcal ) , and a control group given a st and ard brochure on healthy eating and assigned to follow their usual diet . Subjects entered the study after undergoing complete colonoscopy and removal of adenomatous polyps ; they remained in the study for approximately four years , undergoing colonoscopy one and four years after r and omization . RESULTS A total of 1905 of the r and omized subjects ( 91.6 percent ) completed the study . Of the 958 subjects in the intervention group and the 947 in the control group who completed the study , 39.7 percent and 39.5 percent , respectively , had at least one recurrent adenoma ; the unadjusted risk ratio was 1.00 ( 95 percent confidence interval , 0.90 to 1.12 ) . Among subjects with recurrent adenomas , the mean ( + /-SE ) number of such lesions was 1.85+/-0.08 in the intervention group and 1.84+/-0.07 in the control group . The rate of recurrence of large adenomas ( with a maximal diameter of at least 1 cm ) and advanced adenomas ( defined as lesions that had a maximal diameter of at least 1 cm or at least 25 percent villous elements or evidence of high- grade dysplasia , including carcinoma ) did not differ significantly between the two groups . CONCLUSIONS Adopting a diet that is low in fat and high in fiber , fruits , and vegetables does not influence the risk of recurrence of colorectal adenomas BACKGROUND Epidemiologic studies have suggested that vitamin E and beta-carotene may each influence the development of prostate cancer . In the Alpha-Tocopherol , Beta-Carotene Cancer Prevention Study , a controlled trial , we studied the effect of alpha-tocopherol ( a form of vitamin E ) and beta-carotene supplementation , separately or together , on prostate cancer in male smokers . METHODS A total of 29133 male smokers aged 50 - 69 years from southwestern Finl and were r and omly assigned to receive alpha-tocopherol ( 50 mg ) , beta-carotene ( 20 mg ) , both agents , or placebo daily for 5 - 8 years ( median , 6.1 years ) . The supplementation effects were estimated by a proportional hazards model , and two-sided P values were calculated . RESULTS We found 246 new cases of and 62 deaths from prostate cancer during the follow-up period . A 32 % decrease ( 95 % confidence interval [ CI ] = -47 % to -12 % ) in the incidence of prostate cancer was observed among the subjects receiving alpha-tocopherol ( n = 14564 ) compared with those not receiving it ( n = 14569 ) . The reduction was evident in clinical prostate cancer but not in latent cancer . Mortality from prostate cancer was 41 % lower ( 95 % CI = -65 % to -1 % ) among men receiving  alpha-tocopherol .  Among subjects receiving beta-carotene ( n = 14560 ) , prostate cancer incidence was 23 % higher ( 95 % CI = -4%-59 % ) and mortality was 15 % higher ( 95 % CI = -30%-89 % ) compared with those not receiving it ( n = 14573 ) . Neither agent had any effect on the time interval between diagnosis and death . CONCLUSIONS Long-term supplementation with alpha-tocopherol substantially reduced prostate cancer incidence and mortality in male smokers . Other controlled trials are required to confirm the findings The association between vegetable and fruit consumption and  stomach cancer  risk was investigated in the Netherl and s Cohort Study among 120,852 men and women aged 55 - 69 years at the start in September 1986 . Analyses were based on 282 incident stomach cancer cases after 6.3 years of follow-up . Age- and sex-adjusted rate ratios of stomach cancer in increasing quintiles of combined vegetable and fruit consumption were 1.00 , 0.70 , 0.65 , 0.76 , and 0.64 ( p trend = 0.04 ) . Multivariate analysis result ed in rate ratios that were somewhat closer to one ( p trend = 0.14 ) . Furthermore , inverse associations for total vegetables , pulses , raw leafy vegetables , total fruit , citrus fruit , and apples and pears that were observed in crude analyses became weaker or disappeared in multivariate analyses .  Total vegetable , but not fruit , consumption was significantly lower in cases diagnosed in the first follow-up year . In analyses limited to first year cases ( resembling a case-control study ) , rate ratios for increasing tertiles of total vegetable consumption were 1.00 , 0.17 , and 0.18 ( p trend = 0.0001 ) , which may indicate the presence of information bias in case-control studies . This prospect i ve study suggests that vegetable and fruit consumption was not clearly associated with  stomach cancer risk in the Dutch population . The findings of this study are comparable with findings of other cohort studies , but they do not support the findings of case-control studies BACKGROUND Previous epidemiologic studies of fruit and vegetable intake and bladder cancer risk have yielded inconsistent results , especially with regard to the types of fruits and vegetables consumed . We examined total fruit and vegetable intake  , as well as intakes of subtypes of fruits and vegetables , in relation to bladder cancer risk in a large male prospect i ve cohort study . METHODS Two hundred fifty-two cases of incident bladder cancer were diagnosed from 1986 through January 31 , 1996 , among 47,909 men enrolled in the Health Professionals Follow-up Study . Each participant in this cohort completed a 131-item food-frequency question naire in 1986 and subsequently in 1990 and 1994 . We used logistic regression analyses to examine  fruit and vegetable intake in relation to bladder cancer risk , after adjusting for age , history of cigarette smoking , current smoking status , geographic region , total fluid intake , and caloric intake . RESULTS We observed a weak , inverse association that was not statistically significant between total fruit and vegetable intake and bladder cancer risk . Intake of cruciferous vegetables was inversely associated with risk ( relative risk = 0.49 ; 95 % confidence interval = 0.32 - 0.75 , for the highest category of cruciferous vegetable intake compared with the lowest ) , but intakes of yellow or green leafy vegetables or carotenoid-rich vegetables were not associated with risk . Individual cruciferous vegetables , except for coleslaw , were all inversely related to bladder cancer risk , but only the associations for broccoli and cabbage were statistically significant . CONCLUSIONS Data from this study indicate that high cruciferous vegetable consumption may reduce bladder cancer risk , but other vegetables and fruits may not confer appreciable benefits against this cancer BACKGROUND Several recent large prospect i ve cohort studies have failed to demonstrate the presumed protective effect of fruit , vegetable , and dietary fiber consumption on colorectal cancer risk . To further explore this issue , we have examined these associations in a population that consumes relatively low amounts of fruit and vegetables and high amounts of cereals .  METHODS We examined data obtained from a food-frequency question naire used in a population -based prospect i ve mammography screening study of women in central Sweden . Women with colorectal cancer diagnosed through December 31 , 1998 , were identified by linkage to regional cancer registries . Cox proportional hazards models were used to estimate relative risks . All statistical tests were two-sided . RESULTS During an average 9.6 years of follow-up of 61 463 women , we observed 460 incident cases of colorectal cancer ( 291 colon cancers , 159 rectal cancers , and 10 cancers at both sites ) . In the entire study population , total fruit and vegetable consumption was inversely associated with colorectal cancer risk . Subanalyses showed that this association was due largely to fruit consumption . The association was stronger , however , and the dose-response effect was more evident among individuals who consumed the lowest amounts of fruit and vegetables . Individuals who consumed less than 1.5 servings of fruit and vegetables per day had a relative risk for developing colorectal cancer of 1.65 ( 95 % confidence interval = 1.23 to 2.20 ; P(trend ) = .001 ) compared with individuals who consumed more than 2.5 servings . We observed no association between colorectal cancer risk and the consumption of cereal fiber , even at amounts substantially greater than previously examined , or of non-cereal fiber . CONCLUSIONS Individuals who consume very low amounts of fruit and vegetables have the greatest risk of colorectal cancer . Relatively high consumption of cereal fiber does not appear to lower the risk of colorectal cancer BACKGROUND Observational studies suggest that people who consume more fruits and vegetables containing beta carotene have somewhat lower risks of cancer and cardiovascular disease , and earlier basic research suggested plausible mechanisms . Because large r and omized trials of long duration were necessary to test this hypothesis directly , we conducted a trial of beta carotene supplementation . METHODS In a r and omized , double-blind , placebo-controlled trial of beta carotene ( 50 mg on alternate days ) , we enrolled 22,071 male physicians , 40 to 84 years of age , in the United States ; 11 percent were current smokers and 39 percent were former smokers at the beginning of the study in 1982 . By December 31 , 1995 , the scheduled end of the study , fewer than 1 percent had been lost to follow-up , and compliance was 78 percent in the group that received beta carotene . RESULTS Among 11,036 physicians r and omly assigned to receive beta carotene  and 11,035 assigned to receive placebo , there were virtually no early or late differences in the overall incidence of malignant neoplasms or cardiovascular disease , or in overall mortality . In the beta carotene group , 1273 men had any malignant neoplasm  ( except nonmelanoma skin cancer ) , as compared with 1293 in the placebo group ( relative risk , 0.98 ; 95 percent confidence interval , 0.91 to 1.06 ) . There were also no significant differences in the number of cases of lung cancer ( 82 in the beta carotene group vs. 88 in the placebo group ) ; the number of deaths from cancer ( 386 vs. 380 ) , deaths from any cause ( 979 vs. 968 ) , or deaths from cardiovascular disease ( 338 vs. 313 ) ; the number of men with myocardial infa rct ion ( 468 vs. 489 ) ; the number with stroke ( 367 vs. 382 ) ; or the number with any one of the previous three end points ( 967 vs. 972 ) . Among current and former smokers , there were also no significant early or 
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AND RECOMMENDATIONS Overweight/obesity increases the risk for cancers of the oesophagus ( adenocarcinoma ) , colorectum , breast ( postmenopausal ) , endometrium and kidney ; body weight should be maintained in the body mass index range of 18.5 - 25 kg/m(2 ) , and weight gain in adulthood avoided .
Alcohol causes cancers of the oral cavity , pharynx , oesophagus and liver , and a small increase in the risk for breast cancer ; if consumed , alcohol intake should not exceed 2 units/d .
Aflatoxin in foods causes liver cancer , although its importance in the absence of hepatitis virus infections is not clear ; exposure to aflatoxin in foods should be minimised .
Chinese-style salted fish increases the risk for nasopharyngeal cancer , particularly if eaten during childhood , and should be eaten only in moderation .
Fruits and vegetables probably reduce the risk for cancers of the oral cavity , oesophagus , stomach and colorectum , and diets should include at least 400 g/d of total fruits and vegetables .
Preserved meat and red meat probably increase the risk for colorectal cancer ; if eaten , consumption of these foods should be moderate .
Salt preserved foods and high salt intake probably increase the risk for stomach cancer ; overall consumption of salt preserved foods and salt should be moderate .
Very hot drinks and foods probably increase the risk for cancers of the oral cavity , pharynx and oesophagus ; drinks and foods should not be consumed when they are scalding hot .