TY - JOUR
T1 - Dietary Flavonoid Intake and Esophageal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Cohort
AU - Vermeulen, Esther
AU - Zamora-Ros, Raul
AU - Duell, Eric J.
AU - Lujan-Barroso, Leila
AU - Boeing, Heiner
AU - Aleksandrova, Krasimira
AU - Bas Bueno-de-Mesquita, H.
AU - Scalbert, Augustin
AU - Romieu, Isabelle
AU - Fedirko, Veronika
AU - Touillaud, Marina
AU - Fagherazzi, Guy
AU - Perquier, Florence
AU - Molina-Montes, Esther
AU - Chirlaque, Maria-Dolores
AU - Vicente Argüelles, Marcial
AU - Amiano, Pilar
AU - Barricarte, Aurelio
AU - Pala, Valeria
AU - Mattiello, Amalia
AU - Saieva, Calogero
AU - Tumino, Rosario
AU - Ricceri, Fulvio
AU - Trichopoulou, Antonia
AU - Vasilopoulou, Effie
AU - Ziara, Gianna
AU - Crowe, Francesca L.
AU - Khaw, Kay-Thee
AU - Wareham, Nicholas J.
AU - Lukanova, Annekatrin
AU - Grote, Verena A.
AU - Tjønneland, Anne
AU - Halkjær, Jytte
AU - Bredsdorff, Lea
AU - Overvad, Kim
AU - Siersema, Peter D.
AU - Peeters, Petra H. M.
AU - May, Anne M.
AU - Weiderpass, Elisabete
AU - Skeie, Guri
AU - Hjartåker, Anette
AU - Landberg, Rikard
AU - Johansson, Ingegerd
AU - Sonestedt, Emily
AU - Ericson, Ulrika
AU - Riboli, Elio
AU - Gonzalez, Carlos A.
PY - 2013
Y1 - 2013
N2 - 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) (log2) = 0.87, 95% confidence interval (CI): 0.78, 0.98) but not in multivariable models (HR (log2) = 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 (log2) = 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.
AB - 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) (log2) = 0.87, 95% confidence interval (CI): 0.78, 0.98) but not in multivariable models (HR (log2) = 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 (log2) = 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.
KW - Esophageal cancer
KW - European prospective investigation into cancer and nutrition
KW - Flavonoids
KW - Intake
U2 - 10.1093/aje/kwt026
DO - 10.1093/aje/kwt026
M3 - Journal article
VL - 178
SP - 570
EP - 581
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
SN - 0002-9262
IS - 4
ER -
