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. Author manuscript; available in PMC: 2021 Jan 1.
Published in final edited form as: Nutr Cancer. 2019 Jul 23;72(4):568–575. doi: 10.1080/01635581.2019.1644353

Table 2.

Hazard ratios for incident melanoma according to frequency of citrus consumption

Serving Category P for trend
Total Citrus <2/wk 2–4/wk 5–6/wk 1–1.4/d 1.5+/d

No. of person-years 248,899 193,710 90,868 216,254 132,152
No. of cases 245 224 85 243 159
Age-adjusted HR (95% CI) (ref) 1.18 (0.99, 1.42) 0.96 (0.75, 1.22) 1.16 (0.97, 1.38) 1.24 (1.01, 1.51) 0.05
Multivariable-adjusted HR (95% CI) (ref) 1.14 (0.95, 1.37) 0.90 (0.70, 1.16) 1.06 (0.88, 1.28) 1.12 (0.91, 1.37) 0.45

Citrus Juice <1/wk 1/wk 2–4/wk 5–6/wk 1+/d

No. of person-years 382,946 78,667 148,035 53,658 218,576
No. of cases 402 72 145 62 275
Age-adjusted HR (95% CI) (ref) 0.87 (0.68, 1.12) 0.95 (0.78, 1.14) 1.10 (0.85, 1.44) 1.21 (1.03, 1.41) 0.01
Multivariable-adjusted HR (95% CI) (ref) 0.86 (0.67, 1.11) 0.95 (0.78, 1.15) 1.08 (0.82, 1.42) 1.13 (0.96, 1.32) 0.11

Citrus Fruit Never <1/wk 1/wk 2–4/wk 5+/wk

No. of person-years 146,291 338,313 114,702 124,254 158,323
No. of cases 143 384 129 133 167
Age-adjusted HR (95% CI) (ref) 1.15 (0.95, 1.40) 1.15 (0.90, 1.46) 1.10 (0.87, 1.39) 1.09 (0.87, 1.36) 0.87
Multivariable-adjusted HR (95% CI) (ref) 1.05 (0.86, 1.28) 1.03 (0.81, 1.31) 0.97 (0.76, 1.23) 0.95 (0.76, 1.20) 0.44

Non-Citrus Fruit/Juice <0.75/d 0.75–1.2/d 1.3–1.9/d 2.0–2.9/d 3+/d

No. of person-years 143,368 180,183 212,029 192,722 153,580
No. of cases 155 187 229 215 170
Age-adjusted HR (95% CI) (ref) 0.96 (0.78, 1.19) 1.00 (0.82, 1.23) 1.04 (0.85, 1.28) 1.04 (0.83, 1.29) 0.52
Multivariable-adjusted HR (95% CI) (ref) 0.92 (0.73, 1.14) 0.90 (0.73, 1.11) 0.92 (0.74, 1.14) 0.92 (0.73, 1.15) 0.63

Multivariable-adjusted HRs were adjusted for age (continuous), BMI (<25.0, 25.0–29.9, 30.0–34.9, ≥35.0 kg/m2), education (less than high school graduate, high school graduate, some college, college graduate), physical activity (inactive, low activity, moderate activity, high activity), alcohol consumption (continuous), history of NMSC (yes, no), regional solar radiation (300–325, 350, 375–380, 400–430, 475–500 Langleys), skin reaction to sun (no burns, with or without tanning; burns, with or without tanning), average daily time outdoors currently (<30min, 30min - 2hrs, 2+ hrs), and sunscreen SPF use (none, something but don’t know, SPF 2–14, SPF 15–24, SPF 25+)