期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 178, 期 4, 页码 570-581出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwt026
关键词
esophageal cancer; European Prospective Investigation into Cancer and Nutrition; flavonoids; intake
资金
- European Commission: Public Health and Consumer Protection Directorate
- Ligue contre le Cancer
- Institut Gustave Roussy
- Mutuelle Generale de l'Education Nationale
- Institut National de la Sante et de la Recherche Medicale (INSERM) (France)
- German Cancer Aid
- German Cancer Research Center
- German Federal Ministry of Education and Research
- Danish Cancer Society: Health Research Fund (FIS) of the Spanish Ministry of Health [RTICC DR06/0020]
- Hellenic Ministry of Health
- Stavros Niarchos Foundation
- Hellenic Health Foundation
- Italian Association for Research on Cancer
- 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, Skane, Sweden
- Nordforsk-Centre of Excellence Program
- postdoctoral program Fondo de Investigacion Sanitaria (FIS) from the Spanish Ministry of Science and Innovation [CD09/00133]
- Cancer Research UK [14136] Funding Source: researchfish
- Medical Research Council [G1000143, G0401527] Funding Source: researchfish
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.
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