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Clin Nutr. 2018 Oct;37(5):1675-1682. doi: 10.1016/j.clnu.2017.07.014. Epub 2017 Jul 18.

Plasma phytoestrogens concentration and risk of colorectal cancer in two different Asian populations.

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Department of Preventive Medicine, Gachon University College of Medicine, 191 Hambakmoeiro, Yeonsu-Gu, Incheon, South Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehangno, Chongno-gu, Seoul, South Korea.
Division of Medical Science Knowledge Management, Center for Genome Science, Korea Centers for Disease Control and Prevention, 187 Osongsaengmyeong 2-ro, Osong-eup, Cheonju, South Korea.
National Institute of Health and Nutrition, 1-23-1, Toyama, Shinjuku, Tokyo, Japan.
Department of Occupational Health, Hanoi Medical University, 1A Duc Thang Road, North Tu Liem District, Hanoi, Viet Nam; International University of Health and Welfare, 4-3 Kozunomori, Narita, Japan.
Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan.
Department of Radiology, Gachon University, 191 Hambakmoeiro Yeonsu-Gu, Incheon, South Korea.
Department of Preventive Medicine, Konkuk University, 268 Chungwon-daero, Chungju, South Korea.
Noncommunicable Diseases and Health Promotion, World Health Organization Western Pacific Regional Office, United Nations Ave Ermita, Brgy 669 Zone 72, Manila, Philippines.
Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehangno, Chongno-gu, Seoul, South Korea; Seoul National University Cancer Research Institute, 103 Daehangno, Chongno-gu, Seoul, South Korea; Department of Biomedical Science, Seoul National University Graduate School, 103 Daehangno, Chongno-gu, Seoul, South Korea.
Clinical Preventive Medicine Center, Seoul National University Bundang Hospital, 82 Gumi-ro, Bundang-gu, Gyeonggi-do, South Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehangno, Chongno-gu, Seoul, South Korea; Korean Armed Forces Capital Hospital, Yul-dong, Seongnam, South Korea. Electronic address:



To evaluate the relationship between phytoestrogen and colon cancer risk, we quantified plasma isoflavones (Genistein and Daidzein) and lignan (enterolactone) in a Korean nested case-control study and conducted replication study in a Vietnamese case-control study.


Study populations of 101 cases and 391 controls were selected from the Korean Multicenter Cancer Cohort which was constructed from 1993 to 2004. For replication study, Vietnamese hospital-based case-control subjects of 222 cases and 206 controls were selected from 2003 to 2007. The concentrations of plasma genistein, daidzein, and enterolactone were quantified by liquid chromatography-mass spectrometry. Logistic regression models were used to compute odds ratios (ORs) and 95% confidence intervals (CIs), and meta-analysis was conducted to estimate combined ORs (CORs) and 95% Cis of Korean and Vietnamese population in 2014.


Genistein showed a continual decrease in colorectal cancer risk according to level up of the concentration categories in Korean and Vietnamese population (P for trend = 0.032, and 0.001, respectively) and a significantly decreased risk was found at the highest concentration of genistein and daidzein (for the highest category compared to the lowest: COR (95% CI) = 0.46 (0.30-0.69), and COR (95% CI) = 0.54 (0.36-0.82)). When the study population was stratified, the beneficial relationship of genistein with colorectal cancer was observed regardless of sex and anatomical subtype. However, enterolacton level was not associated with colorectal cancer risk.


High plasma levels of isoflavones had relationship with a decreased risk of colorectal cancer, regardless of different ethnic background.


Colon cancer; Isoflavones; Korean; Phytoestrogens; Rectal cancer; Vietnamese


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