Experimental studies in animals and epidemiological evidence supporting the health benefits from apples encouraged the authors to assess the potential protective impact of apples on the risk of colorectal cancer in the course of the hospital based case-control study. A total of 186 incident cases of colorectal cancer - for which the information on histology, anatomic location, and stage of cancer were available - have been enrolled to the study. The comparison group included 211 controls chosen from the patients of the same hospital with no history of cancer and admitted for treatment of non-neoplastic conditions. Interviews of both cases and controls were conducted in hospital settings by trained interviewers. The results showed that the risk of colorectal cancer inversely correlated with daily number of apple servings, but the significant reduction of OR estimates were observed for an intake of one or more apple servings daily (OR = 0.37, 95%CI: 0.15 − 0.91). The risk of colorectal cancer was estimated from the multivariate logistic model including a set of potential confounding variables, such as, demographic characteristics of subjects (age, gender, place of residency, marital status and occupational activity), total energy intake (in tertiles) and intake of vegetables (number of servings per day). No fruits except for apples were significantly associated with the reduced risk of colorectal cancer. The reduction of colorectal risk associated with apple consumption may result from their rich content of flavonoid and other polyphenols, which can inhibit cancer onset and cell proliferation.
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