Fig 1.

Hazard ratios (HRs) for incident melanomas comparing extreme citrus consumption categories at lags from 0 to 14 years. HRs were computed for overall citrus consumption comparing ≥ once per day versus < twice per week, for grapefruit and grapefruit juice consumption comparing ≥ twice per week versus never, for orange consumption comparing ≥ three times per week versus never, and for orange juice consumption comparing ≥ five times per week versus < once per week. In lagged analyses, we added different intervals from 2 to 14 years between dietary assessment and cohort follow-up (eg, we used citrus consumption from 1984 questionnaire for follow-up from 1986 to 1988 for 2-year lag analysis and for follow-up from 1988 to 1990 for 4-year lag analysis). Multivariable HRs were adjusted for age, family history of melanoma, natural hair color, No. of arm moles, sunburn susceptibility as child or adolescent, No. of lifetime blistering sunburns, cumulative ultraviolet flux since baseline, average time spent in direct sunlight since high school, body mass index, physical activity, smoking status, and intake of total energy, alcohol, coffee, and vitamin C from supplements. Analyses for consumption of each individual citrus product were also adjusted for consumption of other individual citrus products. Analyses for women were also adjusted for menopausal status and postmenopausal hormone use (Table 2). Results among women and men were pooled using random-effects model. HRs for other categories of citrus consumption in lagged analyses are shown in Data Supplement. Vertical lines represent 95% CIs; x-axis indicates years of lag.