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

Raul Zamora-Ros, Dinesh K. Barupal, Joseph A. Rothwell, Mazda Jenab, Veronika Fedirko, Isabelle Romieu, Krasimira Aleksandrova, Kim Overvad, Cecilie Kyrø, Anne Tjønneland, Aurélie Affret, Mathilde His, Marie Christine Boutron-Ruault, Verena Katzke, Tilman Kühn, Heiner Boeing, Antonia Trichopoulou, Androniki Naska, Maria Kritikou, Calogero SaievaClaudia Agnoli, Maria Santucci de Magistris, Rosario Tumino, Francesca Fasanelli, Elisabete Weiderpass, Guri Skeie, Susana Merino, Paula Jakszyn, Maria José Sánchez, Miren Dorronsoro, Carmen Navarro, Eva Ardanaz, Emily Sonestedt, Ulrika Ericson, Lena Maria Nilsson, Stina Bodén, H. Bas Bueno-de-Mesquita, Petra H. Peeters, Aurora Perez-Cornago, Nicholas J. Wareham, Kay Thee Khaw, Heinz Freisling, Amanda J. Cross, Elio Riboli, Augustin Scalbert

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1836-1844
Number of pages9
JournalInternational Journal of Cancer
Volume140
Issue number8
DOIs
Publication statusPublished - Apr 15 2017

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Keywords

  • colorectal cancer
  • diet
  • EPIC
  • flavonoids
  • prospective cohort

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Zamora-Ros, R., Barupal, D. K., Rothwell, J. A., Jenab, M., Fedirko, V., Romieu, I., Aleksandrova, K., Overvad, K., Kyrø, C., Tjønneland, A., Affret, A., His, M., Boutron-Ruault, M. C., Katzke, V., Kühn, T., Boeing, H., Trichopoulou, A., Naska, A., Kritikou, M., ... Scalbert, A. (2017). Dietary flavonoid intake and colorectal cancer risk in the European prospective investigation into cancer and nutrition (EPIC) cohort. International Journal of Cancer, 140(8), 1836-1844. https://doi.org/10.1002/ijc.30582