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Dietary Flavonoid Intake and Esophageal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Cohort

Vermeulen, Esther ; Zamora-Ros, Raul ; Duell, Eric J. ; Lujan-Barroso, Leila ; Boeing, Heiner ; Aleksandrova, Krasimira ; Bueno-de-Mesquita, H. Bas ; Scalbert, Augustin ; Romieu, Isabelle and Fedirko, Veronika , et al. (2013) In American Journal of Epidemiology 178(4). p.570-581
Abstract
We prospectively investigated dietary flavonoid intake and esophageal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,312 adult subjects from 10 European countries. At baseline, country-specific validated dietary questionnaires were used. During a mean follow-up of 11 years (1992-2010), there were 341 incident esophageal cancer cases, of which 142 were esophageal adenocarcinoma (EAC), 176 were esophageal squamous cell carcinoma (ESCC), and 23 were other types of esophageal cancer. In crude models, a doubling in total dietary flavonoid intake was inversely associated with esophageal cancer risk (hazard ratio (HR) (log(2))=0.87, 95% confidence interval (CI): 0.78, 0.98)... (More)
We prospectively investigated dietary flavonoid intake and esophageal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,312 adult subjects from 10 European countries. At baseline, country-specific validated dietary questionnaires were used. During a mean follow-up of 11 years (1992-2010), there were 341 incident esophageal cancer cases, of which 142 were esophageal adenocarcinoma (EAC), 176 were esophageal squamous cell carcinoma (ESCC), and 23 were other types of esophageal cancer. In crude models, a doubling in total dietary flavonoid intake was inversely associated with esophageal cancer risk (hazard ratio (HR) (log(2))=0.87, 95% confidence interval (CI): 0.78, 0.98) but not in multi-variable models (HR (log(2))=0.97, 95% CI: 0.86, 1.10). After covariate adjustment, no statistically significant association was found between any flavonoid subclass and esophageal cancer, EAC, or ESCC. However, among current smokers, flavonols were statistically significantly associated with a reduced esophageal cancer risk (HR (log(2)) = 0.72, 95% CI: 0.56, 0.94), whereas total flavonoids, flavanols, and flavan-3-ol monomers tended to be inversely associated with esophageal cancer risk. No associations were found in either never or former smokers. These findings suggest that dietary flavonoid intake was not associated with overall esophageal cancer, EAC, or ESCC risk, although total flavonoids and some flavonoid subclasses, particularly flavonols, may reduce the esophageal cancer risk among current smokers. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
esophageal cancer, European Prospective Investigation into Cancer and, Nutrition, flavonoids, intake
in
American Journal of Epidemiology
volume
178
issue
4
pages
570 - 581
publisher
Oxford University Press
external identifiers
  • wos:000323045400008
  • scopus:84881602915
  • pmid:23652166
ISSN
0002-9262
DOI
10.1093/aje/kwt026
language
English
LU publication?
yes
id
170c3928-b7bb-4060-acb2-2c8679335003 (old id 4027203)
date added to LUP
2016-04-01 10:54:30
date last changed
2022-03-27 20:42:54
@article{170c3928-b7bb-4060-acb2-2c8679335003,
  abstract     = {{We prospectively investigated dietary flavonoid intake and esophageal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,312 adult subjects from 10 European countries. At baseline, country-specific validated dietary questionnaires were used. During a mean follow-up of 11 years (1992-2010), there were 341 incident esophageal cancer cases, of which 142 were esophageal adenocarcinoma (EAC), 176 were esophageal squamous cell carcinoma (ESCC), and 23 were other types of esophageal cancer. In crude models, a doubling in total dietary flavonoid intake was inversely associated with esophageal cancer risk (hazard ratio (HR) (log(2))=0.87, 95% confidence interval (CI): 0.78, 0.98) but not in multi-variable models (HR (log(2))=0.97, 95% CI: 0.86, 1.10). After covariate adjustment, no statistically significant association was found between any flavonoid subclass and esophageal cancer, EAC, or ESCC. However, among current smokers, flavonols were statistically significantly associated with a reduced esophageal cancer risk (HR (log(2)) = 0.72, 95% CI: 0.56, 0.94), whereas total flavonoids, flavanols, and flavan-3-ol monomers tended to be inversely associated with esophageal cancer risk. No associations were found in either never or former smokers. These findings suggest that dietary flavonoid intake was not associated with overall esophageal cancer, EAC, or ESCC risk, although total flavonoids and some flavonoid subclasses, particularly flavonols, may reduce the esophageal cancer risk among current smokers.}},
  author       = {{Vermeulen, Esther and Zamora-Ros, Raul and Duell, Eric J. and Lujan-Barroso, Leila and Boeing, Heiner and Aleksandrova, Krasimira and Bueno-de-Mesquita, H. Bas and Scalbert, Augustin and Romieu, Isabelle and Fedirko, Veronika and Touillaud, Marina and Fagherazzi, Guy and Perquier, Florence and Molina-Montes, Esther and Chirlaque, Maria-Dolores and Argueelles, Marcial Vicente and Amiano, Pilar and Barricarte, Aurelio and Pala, Valeria and Mattiello, Amalia and Saieva, Calogero and Tumino, Rosario and Ricceri, Fulvio and Trichopoulou, Antonia and Vasilopoulou, Effie and Ziara, Gianna and Crowe, Francesca L. and Khaw, Kay-Thee and Wareham, Nicholas J. and Vasilopoulou, Effie and Ziara, Gianna and Crowe, Francesca L. and Khaw, Kay-Thee and Wareham, Nicholas J. and Lukanova, Annekatrin and Grote, Verena A. and Tjonneland, Anne and Halkjaer, Jytte and Bredsdorff, Lea and Overvad, Kim and Siersema, Peter D. and Peeters, Petra H. M. and May, Anne M. and Weiderpass, Elisabete and Skeie, Guri and Hjartaker, Anette and Landberg, Rikard and Johansson, Ingegerd and Sonestedt, Emily and Ericson, Ulrika and Riboli, Elio and Gonzalez, Carlos A.}},
  issn         = {{0002-9262}},
  keywords     = {{esophageal cancer; European Prospective Investigation into Cancer and; Nutrition; flavonoids; intake}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{570--581}},
  publisher    = {{Oxford University Press}},
  series       = {{American Journal of Epidemiology}},
  title        = {{Dietary Flavonoid Intake and Esophageal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Cohort}},
  url          = {{http://dx.doi.org/10.1093/aje/kwt026}},
  doi          = {{10.1093/aje/kwt026}},
  volume       = {{178}},
  year         = {{2013}},
}