Dietary flavonoid intake and colorectal cancer risk in the European prospective investigation into cancer and nutrition (EPIC) cohort
AuthorZamora-Ros, Raul; Barupal, Dinesh Kumar; Rothwell, Joseph A.; Jenab, Mazda; Fedirko, Veronika; Romieu, Isabelle; Aleksandrova, Krasimira; Overvad, Kim; Kyrø, Cecilie; Tjønneland, Anne; Affret, Aurélie; His, Mathilde; Boutron-Ruault, Marie-Christine; Katzke, Verena; Kühn, Tilman; Boeing, Heiner; Trichopoulou, Antonia; Naska, Androniki; Kritikou, Maria; Saieva, Calogero; Agnoli, Claudia; Santucci de Magistris, Maria; Tumino, Rosario; Fasanelli, Francesca; Weiderpass, Elisabete; Skeie, Guri; Merino, Susana; Jakszyn, Paula; Sánchez, María-José; Dorronsoro, Miren; Navarro, Carmen; Ardanaz, Eva; Sonestedt, Emily; Ericson, Ulrika; Maria Nilsson, Lena; Bodén, Stina; Bueno-De-Mesquita, Hendrik Bastiaan; Peeters, Petra H.; Perez-Cornago, Aurora; Wareham, Nicholas J.; Khaw, Kay-Thee; Freisling, Heinz; Cross, Amanda J.; Riboli, Elio; Scalbert, Augustin
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.
This is the peer reviewed version of the following article: Zamora-Ros, R., Barupal, D., Rothwell, J.A., Jenab, M., Fedirko, V., Romieu, I., ... 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, which has been published in final form at https://doi.org/10.1002/ijc.30582. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.