TY - JOUR
T1 - Dietary flavonoid and lignan intake and breast cancer risk according to menopause and hormone receptor status in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study
AU - Zamora-Ros, Raul
AU - Ferrari, Pietro
AU - González, Carlos A.
AU - Tjønneland, Anne
AU - Olsen, Anja
AU - Bredsdorff, Lea
AU - Overvad, Kim
AU - Touillaud, Marina
AU - Perquier, Florence
AU - Fagherazzi, Guy
AU - Lukanova, Annekatrin
AU - Tikk, Kaja
AU - Aleksandrova, Krasimira
AU - Boeing, Heiner
AU - Trichopoulou, Antonia
AU - Trichopoulos, Dimitrios
AU - Dilis, Vardis
AU - Masala, Giovanna
AU - Sieri, Sabina
AU - Mattiello, Amalia
AU - Tumino, Rosario
AU - Ricceri, Fulvio
AU - Bueno-De-Mesquita, H. Bas
AU - Peeters, Petra H.M.
AU - Weiderpass, Elisabete
AU - Skeie, Guri
AU - Engeset, Dagrun
AU - Menéndez, Virginia
AU - Travier, Noémie
AU - Molina-Montes, Esther
AU - Amiano, Pilar
AU - Chirlaque, Maria Dolores
AU - Barricarte, Aurelio
AU - Wallström, Peter
AU - Sonestedt, Emily
AU - Sund, Malin
AU - Landberg, Rikard
AU - Khaw, Kay Thee
AU - Wareham, Nicholas J.
AU - Travis, Ruth C.
AU - Scalbert, Augustin
AU - Ward, Heather A.
AU - Riboli, Elio
AU - Romieu, Isabelle
N1 - Funding Information:
Number of breast cancer cases by hormone receptor status: ER-/PR- (n = 1,050), ER-/PR? (n = 217), ER?/PR- (n = 1,133), ER?/PR? (n = 3,653) EPIC European Prospective Investigation into Cancer and Nutrition, ER oestrogen receptor, PR progesterone receptor a Multivariable model: stratified by centre and age (1 year) and adjusted for baseline menopausal status (pre-menopausal plus unknown, postmenopausal plus women who underwent an ovariectomy), weight (kg), height (cm), smoking status (never, former, current, unknown), educational level (none, primary, technical, secondary, university or higher, unknown), physical activity (inactive, moderately inactive, moderately active, active, unknown), age at menarche (\12, 12–14, [14 year, unknown), age at first full-term birth (nulliparous, \21, 21–30, [30 year), ever use of contraceptive pills (never, ever, unknown), ever use of hormones (never, ever, unknown), age at menopause (\=50,[50 year), energy intake (kcal/day), alcohol intake (g/day), and fibre intake (g/day) Acknowledgements This work was supported by the European Commission: Public Health and Consumer Protection Directorate 1993–2004; Research Directorate-General 2005; 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); German Federal Ministry of Education and Research; Danish Cancer Society: Health Research Fund (FIS) of the Spanish Ministry of Health (RTICC DR06/0020/0091); the participating regional governments from Asturias, Andalucía, Murcia, Navarra and Basque Country and the Catalan Institute of Oncology of Spain; Cancer Research UK; Medical Research Council, UK; Hellenic Health Foundation, Greece; Italian Association for Research on Cancer-AIRC-Milan, Italy; Compagnia San Paolo, Italy; Dutch Ministry of Public Health, Welfare and Sports; Dutch Ministry of Health; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek Nederland); World Cancer Research Fund (WCRF); Statistics Netherlands (The Netherlands); Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; and Nordforsk—Centre of Excellence programme. Some authors are partners of ECNIS, a network of excellence of the 6 Frame Program of the European Commission. R.Z.R. is thankful for a postdoctoral programme, Fondo de Investigación Sanitaria (FIS; No. CD09/ 00133), from the Spanish Ministry of Science and Innovation.
PY - 2013/5
Y1 - 2013/5
N2 - Evidence on the association between dietary flavonoids and lignans and breast cancer (BC) risk is inconclusive, with the possible exception of isoflavones in Asian countries. Therefore, we investigated prospectively dietary total and subclasses of flavonoid and lignan intake and BC risk according to menopause and hormonal receptor status in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 334,850 women, mostly aged between 35 and 70 years from ten European countries. At baseline, country-specific validated dietary questionnaires were used. A flavonoid and lignan food composition database was developed from the US Department of Agriculture, the Phenol-Explorer and the UK Food Standards Agency databases. Cox regression models were used to analyse the association between dietary flavonoid/lignan intake and the risk of developing BC. During an average 11.5-year follow-up, 11,576 incident BC cases were identified. No association was observed between the intake of total flavonoids [hazard ratio comparing fifth to first quintile (HRQ5-Q1) 0.97, 95 % confidence interval (CI): 0.90-1.04; P trend = 0.591], isoflavones (HRQ5-Q1 1.00, 95 % CI: 0.91-1.10; P trend = 0.734), or total lignans (HRQ5-Q1 1.02, 95 % CI: 0.93-1.11; P trend = 0.469) and overall BC risk. The stratification of the results by menopausal status at recruitment or the differentiation of BC cases according to oestrogen and progesterone receptors did not affect the results. This study shows no associations between flavonoid and lignan intake and BC risk, overall or after taking into account menopausal status and BC hormone receptors.
AB - Evidence on the association between dietary flavonoids and lignans and breast cancer (BC) risk is inconclusive, with the possible exception of isoflavones in Asian countries. Therefore, we investigated prospectively dietary total and subclasses of flavonoid and lignan intake and BC risk according to menopause and hormonal receptor status in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 334,850 women, mostly aged between 35 and 70 years from ten European countries. At baseline, country-specific validated dietary questionnaires were used. A flavonoid and lignan food composition database was developed from the US Department of Agriculture, the Phenol-Explorer and the UK Food Standards Agency databases. Cox regression models were used to analyse the association between dietary flavonoid/lignan intake and the risk of developing BC. During an average 11.5-year follow-up, 11,576 incident BC cases were identified. No association was observed between the intake of total flavonoids [hazard ratio comparing fifth to first quintile (HRQ5-Q1) 0.97, 95 % confidence interval (CI): 0.90-1.04; P trend = 0.591], isoflavones (HRQ5-Q1 1.00, 95 % CI: 0.91-1.10; P trend = 0.734), or total lignans (HRQ5-Q1 1.02, 95 % CI: 0.93-1.11; P trend = 0.469) and overall BC risk. The stratification of the results by menopausal status at recruitment or the differentiation of BC cases according to oestrogen and progesterone receptors did not affect the results. This study shows no associations between flavonoid and lignan intake and BC risk, overall or after taking into account menopausal status and BC hormone receptors.
KW - Breast cancer
KW - EPIC
KW - Flavonoids
KW - Hormone receptors
KW - Lignans
UR - http://www.scopus.com/inward/record.url?scp=84877577240&partnerID=8YFLogxK
U2 - 10.1007/s10549-013-2483-4
DO - 10.1007/s10549-013-2483-4
M3 - Article
C2 - 23572295
AN - SCOPUS:84877577240
SN - 0167-6806
VL - 139
SP - 163
EP - 176
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 1
ER -