Towards integrated cancer prevention: the potential role of fruits and vegetables
Editorial
In its last 2025 report, the World Cancer Research Fund (WCRF) underscored the need for an integrated cancer prevention strategy promoting the adoption of a healthy dietary pattern, regular physical activity, weight management and smoking avoidance (WCRF, 2025). This call comes in the context of a rapidly growing cancer burden :
The increase in cancer incidence is partly driven by demographic changes and an aging population but is also influenced by changing prevalence of modifiable risk factors – diet, alcohol consumption, tobacco use, excess body weight, etc. – which together account for around 40% of cancer cases (WHO, 2025). Importantly, many of these factors also contribute to other non-communicable diseases, such as diabetes and obesity, which may in turn further increase cancer risk.
Within this framework, fruit and vegetables consumption represents a central component of a healthy dietary pattern for cancer prevention. Fruits and vegetables provide dietary fiber, vitamins, minerals and bioactive compounds that influence multiple biological pathways that can play a role in cancer development. Accumulating evidence suggests that adequate fruit and vegetable intake is associated with a reduced risk of certain cancers, notably those of the aerodigestive tract, colorectum, breast, and prostate.
Despite this evidence, fruit and vegetable consumption remains below the current recommended intake levels in many populations. This month’s review brings together recent scientific insights on the potential role of fruits and vegetables in cancer prevention.
The first article is a dose-response meta-analysis of 17 scientific studies examining the relationship between cruciferous vegetable intake and colon cancer (Lai et al., 2025). The article reports a potential inverse association between higher consumption of cruciferous vegetables and colon cancer incidence, with a progressive reduction in risk as intake increases. These findings could be explained by the presence of glucosinolates in cruciferous vegetables, which are known to exert chemopreventive properties.
The second article explores the association between fruits and vegetables colours and gastrointestinal cancer risk in a cohort of more than 11 000 participants over a mean follow-up of 8 years (Cho et al., 2025). The study reports a significant inverse association between the consumption of white-coloured fruits and vegetables and white-coloured fruits alone with gastrointestinal cancer risk. These foods are rich in flavones, such as apigenin and luteolin, which may partly explain the observed potential protective effects. In addition, certain bulbs included in this group contain bioactive compounds such as allicin, while white-colored fruits may contribute to cancer protection through specific phytochemicals. Other colour groups were significantly associated with a reduced risk of cancers only in specific population subgroups.
The final article examines the association between dietary flavonoid intake and cancer mortality in 14,029 participants from the NHANES cohort (Zhou et al., 2023). Among the different flavonoid classes, higher intakes of flavonols, largely derived from fruits and vegetables, were associated with lower overall cancer mortality. Compared with participants in the lowest quartile of flavonol intake (< 6,8 mg/day), those in the higher quartiles had a significantly reduced risk of cancer-related death. In addition, higher intakes of peonidin, naringenin and catechins were inversely associated with cancer mortality, with stronger associations observed among former smokers and light or former drinkers, highlighting the relevance of fruit- and vegetable-rich diets within broader lifestyle changes.
Taken together, these findings reinforce the importance of consuming a wide variety of fruits and vegetables as part of a healthy diet to help reduce certain cancer risk. However, diet must be embedded with a broader healthy lifestyle, tailored to individual contexts, and supported by public health policies.
Professor Gunter is Chair in Cancer Epidemiology and Prevention at the School of Public Health, Imperial College London and co-directs the Cancer Epidemiology and Prevention Research Unit based at Imperial College and the Institute of Cancer Research. He holds a degree in biochemistry from Oxford University and a Ph.D in molecular epidemiology from Cambridge University. He undertook postdoctoral training at the U.S National Cancer Institute and has held faculty positions at Albert Einstein College of Medicine in New York, Imperial College and previously headed the Nutrition and Metabolism Branch at IARC.
His research focus is understanding the role of obesity, nutrition and metabolism in cancer development and prognosis, with an emphasis on studying the mechanisms linking metabolic dysfunction and endocrine pathways with cancer. He is particularly interested in integrating population-based studies with experimental approaches to identify causal mechanisms that could be targeted for cancer prevention strategies. He currently leads several large-scale multi-disciplinary projects focused on identifying novel causes of cancer by combining molecular tools such as proteomics and metabolomics applied to prospective cohorts with experimental studies such as in DISCERN and also using human interventions (PROMINENT). Marc serves as a coordinator of the European Prospective Investigation into Cancer and Nutrition (EPIC), one of the largest prospective cohort studies in the world.