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

• Type of Material: Article
• Authors: Raul Zamora-Ros, International Agency for Research on Cancer; Dinesh Barupal, International Agency for Research on Cancer; Joseph A. Rothwell, International Agency for Research on Cancer; Mazda Jenab, International Agency for Research on Cancer; Veronika Fedirko, Emory University; Isabelle Romieu, Emory University; Krasimira Aleksandrova, German Institute of Human Nutrition Potsdam-Rehbrücke; Kim Overvad, Aarhus University; Cecilie Kyro, Danish Cancer Society; Anne Tjonneland, Danish Cancer Society; Aurelie Affret, Universite Paris-Sud; Mathilde His, Universite Paris-Sud; Marie-Christine Boutron-Ruault, Universite Paris-Sud; Verena Katzke, German Cancer Research Center; Tilman Kuehn, German Cancer Research Center
• Language: English
• Date: 2017-04-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 UIC
• Final Published Version (URL): http://dx.doi.org/10.1002/ijc.30582
• Title of Journal or Parent Work: International Journal of Cancer
• ISSN: 0020-7136
• Volume: 140
• Issue: 8
• Start Page: 1836
• End Page: 1844
• Grant/Funding Information: The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer.; The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); European Research Council (ERC-2009-AdG 232997); Health Research Fund (FIS): PI13/00061 to Granada; PI13/01162 to EPIC-Murcia, Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, AGAUR, Generalitat de Catalunya (exp. 2014 SGR 726), The Health Research Funds RD12/0036/0018; cofunded by European Regional Development Fund (ERDF) “A way to buid Europe (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (United Kingdom).; Grant sponsor:Institut National du Cancer, Paris;Grant number:INCa grants 2011–105; This study was supported by the Institut National du Cancer, Paris (INCa grants 2011-105).
• Keywords: colorectal cancer; BIOMARKERS; Oncology; LIGNAN INTAKE; flavonoids; ASSOCIATIONS; Life Sciences & Biomedicine; RECURRENCE; prospective cohort; POLYPHENOLS; CALIBRATION; diet; Science & Technology; EPIC; PREVENTION; HEALTH
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Oncology; Health Sciences, Hygiene

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.