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Int J Cancer. 2016 Oct 1;139(7):1480-92. doi: 10.1002/ijc.30190. Epub 2016 Jun 10.

Flavonoid and lignan intake and pancreatic cancer risk in the European prospective investigation into cancer and nutrition cohort.

Author information

1
Andalusian School of Public Health, Instituto De Investigación Biosanitaria Ibs, GRANADA, Hospitales Universitarios De Granada/Universidad De Granada, Granada, Spain.
2
CIBERESP, CIBER Epidemiología Y Salud Pública, Spain.
3
Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France.
4
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
5
Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands.
6
Department of Epidemiology and Biostatistics, the School of Public Health, Imperial College London, London, United Kingdom.
7
Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
8
Global eHealth Unit, Department of Primary Care and Public Health, the School of Public Health, Imperial College London, London, United Kingdom.
9
Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-Idibell), Barcelona, Spain.
10
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
11
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
12
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
13
The Medical Biobank at Umeå University, Umeå, Sweden.
14
Molecular and Genetic Epidemiology Unit, HuGeF-Human Genetics Foundation, Torino, Italy.
15
Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Naples, Italy.
16
Epidemiology and Prevention Unit Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
17
Cancer Registry ASP, Ragusa, Italy.
18
Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy.
19
Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastián, Spain.
20
Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
21
Public Health Institute of Navarra, Pamplona, Spain.
22
Public Health Directorate, Asturias, Spain.
23
Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø, Norway.
24
Department of Research, Cancer Registry of Norway, Oslo, Norway.
25
Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
26
Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden.
27
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands.
28
Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
29
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
30
Hellenic Health Foundation, Athens, Greece.
31
WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology, and Medical Statistics, University of Athens Medical School, Athens, Greece.
32
University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
33
Epidemiology Unit, Medical Research Council, Cambridge, United Kingdom.
34
Danish Cancer Society Research Center, Copenhagen, Denmark.
35
Inserm, CESP Centre for Research in Epidemiology and Population Health, France.

Abstract

Despite the potential cancer preventive effects of flavonoids and lignans, their ability to reduce pancreatic cancer risk has not been demonstrated in epidemiological studies. Our aim was to examine the association between dietary intakes of flavonoids and lignans and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 865 exocrine pancreatic cancer cases occurred after 11.3 years of follow-up of 477,309 cohort members. Dietary flavonoid and lignan intake was estimated through validated dietary questionnaires and the US Department of Agriculture (USDA) and Phenol Explorer databases. Hazard ratios (HR) and 95% confidence intervals (CIs) were calculated using age, sex and center-stratified Cox proportional hazards models, adjusted for energy intake, body mass index (BMI), smoking, alcohol and diabetes status. Our results showed that neither overall dietary intake of flavonoids nor of lignans were associated with pancreatic cancer risk (multivariable-adjusted HR for a doubling of intake = 1.03, 95% CI: 0.95-1.11 and 1.02; 95% CI: 0.89-1.17, respectively). Statistically significant associations were also not observed by flavonoid subclasses. An inverse association between intake of flavanones and pancreatic cancer risk was apparent, without reaching statistical significance, in microscopically confirmed cases (HR for a doubling of intake = 0.96, 95% CI: 0.91-1.00). In conclusion, we did not observe an association between intake of flavonoids, flavonoid subclasses or lignans and pancreatic cancer risk in the EPIC cohort.

KEYWORDS:

cohort; diet; flavonoids; lignans; pancreatic cancer

PMID:
27184434
PMCID:
PMC4949532
DOI:
10.1002/ijc.30190
[Indexed for MEDLINE]
Free PMC Article

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