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Int J Cancer. 2017 Apr 15;140(8):1836-1844. doi: 10.1002/ijc.30582. Epub 2017 Jan 19.

Dietary flavonoid intake and colorectal cancer risk in the European prospective investigation into cancer and nutrition (EPIC) cohort.

Author information

1
Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France.
2
Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
3
Genome Center, University of California, Davis, CA.
4
Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA.
5
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
6
Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
7
Danish Cancer Society Research Center, Copenhagen, Denmark.
8
Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.
9
Institut Gustave Roussy, Villejuif, F-94805, France.
10
Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
11
Hellenic Health Foundation, Athens, Greece.
12
WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Greece.
13
Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
14
Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
15
Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy.
16
Cancer Registry and Histopathology Unit, "Civic M.P. Arezzo" Hospital, ASP, Ragusa, Italy.
17
Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy.
18
Città della Salute e della Scienza Hospital, Turin, Italy.
19
Department of Community Medicine, Faculty of Health Sciences, UiT The Artic University of Tromsø, Tromsø, Norway.
20
Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
21
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
22
Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
23
Public Health Directorate, Asturias, Spain.
24
Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Granada Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
25
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
26
Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Spain.
27
Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
28
Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain.
29
Navarre Public Health Institute, Pamplona, Spain.
30
IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
31
Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
32
Nutritional Research and Arcum, Arctic Research Centre at Umeå University, Umeå, Sweden.
33
Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
34
Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
35
School of Public Health, Imperial College London, London, United Kingdom.
36
Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
37
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
38
Cancer Epidemiology Unit, University of Oxford, United Kingdom.
39
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
40
Department of Public Health and Primary Care, University of Cambridge, United Kingdom.

Abstract

Flavonoids have been shown to inhibit colon cancer cell proliferation in vitro and protect against colorectal carcinogenesis in animal models. However, epidemiological evidence on the potential role of flavonoid intake in colorectal cancer (CRC) development remains sparse and inconsistent. We evaluated the association between dietary intakes of total flavonoids and their subclasses and risk of development of CRC, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cohort of 477,312 adult men and women were recruited in 10 European countries. At baseline, dietary intakes of total flavonoids and individual subclasses were estimated using centre-specific validated dietary questionnaires and composition data from the Phenol-Explorer database. During an average of 11 years of follow-up, 4,517 new cases of primary CRC were identified, of which 2,869 were colon (proximal = 1,298 and distal = 1,266) and 1,648 rectal tumours. No association was found between total flavonoid intake and the risk of overall CRC (HR for comparison of extreme quintiles 1.05, 95% CI 0.93-1.18; p-trend = 0.58) or any CRC subtype. No association was also observed with any intake of individual flavonoid subclasses. Similar results were observed for flavonoid intake expressed as glycosides or aglycone equivalents. Intake of total flavonoids and flavonoid subclasses, as estimated from dietary questionnaires, did not show any association with risk of CRC development.

KEYWORDS:

EPIC; colorectal cancer; diet; flavonoids; prospective cohort

PMID:
28006847
PMCID:
PMC6241848
DOI:
10.1002/ijc.30582
[Indexed for MEDLINE]
Free PMC Article

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