title: Dietary flavonoid intake and esophageal cancer risk in the European prospective investigation into cancer and nutrition cohort.
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) (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.
authors: Unit of Nutrition, Environment, and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
authors: Esther
authors: E
authors: Vermeulen
authors: Raul
authors: R
authors: Zamora-Ros
authors: Eric J
authors: EJ
authors: Duell
authors: Leila
authors: L
authors: Luján-Barroso
authors: Heiner
authors: H
authors: Boeing
authors: Krasimira
authors: K
authors: Aleksandrova
authors: H Bas
authors: HB
authors: Bueno-de-Mesquita
authors: Augustin
authors: A
authors: Scalbert
authors: Isabelle
authors: I
authors: Romieu
authors: Veronika
authors: V
authors: Fedirko
authors: Marina
authors: M
authors: Touillaud
authors: Guy
authors: G
authors: Fagherazzi
authors: Florence
authors: F
authors: Perquier
authors: Esther
authors: E
authors: Molina-Montes
authors: Maria-Dolores
authors: MD
authors: Chirlaque
authors: Marcial
authors: M
authors: Vicente Argüelles
authors: Pilar
authors: P
authors: Amiano
authors: Aurelio
authors: A
authors: Barricarte
authors: Valeria
authors: V
authors: Pala
authors: Amalia
authors: A
authors: Mattiello
authors: Calogero
authors: C
authors: Saieva
authors: Rosario
authors: R
authors: Tumino
authors: Fulvio
authors: F
authors: Ricceri
authors: Antonia
authors: A
authors: Trichopoulou
authors: Effie
authors: E
authors: Vasilopoulou
authors: Gianna
authors: G
authors: Ziara
authors: Francesca L
authors: FL
authors: Crowe
authors: Kay-Thee
authors: KT
authors: Khaw
authors: Nicholas J
authors: NJ
authors: Wareham
authors: Annekatrin
authors: A
authors: Lukanova
authors: Verena A
authors: VA
authors: Grote
authors: Anne
authors: A
authors: Tjønneland
authors: Jytte
authors: J
authors: Halkjær
authors: Lea
authors: L
authors: Bredsdorff
authors: Kim
authors: K
authors: Overvad
authors: Peter D
authors: PD
authors: Siersema
authors: Petra H M
authors: PH
authors: Peeters
authors: Anne M
authors: AM
authors: May
authors: Elisabete
authors: E
authors: Weiderpass
authors: Guri
authors: G
authors: Skeie
authors: Anette
authors: A
authors: Hjartåker
authors: Rikard
authors: R
authors: Landberg
authors: Ingegerd
authors: I
authors: Johansson
authors: Emily
authors: E
authors: Sonestedt
authors: Ulrika
authors: U
authors: Ericson
authors: Elio
authors: E
authors: Riboli
authors: Carlos A
authors: CA
authors: González
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology; D004032:Diet / Q000009:adverse effects*; D004034:Diet Surveys; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005419:Flavonoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects*
chemical_list: D005419:Flavonoids
keywords: European Prospective Investigation into Cancer and Nutrition; esophageal cancer; flavonoids; intake