Bandera EV, King M, Chandran U, Paddock LE, Rodriguez-Rodriguez L, Olson SHPhytoestrogen consumption from foods and supplements and epithelial ovarian cancer risk: a population-based case control study. BMC Womens Health 11: 40

Cancer Prevention and Control Program/Division of Surgical Oncology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
BMC Women's Health (Impact Factor: 1.5). 09/2011; 11(1):40. DOI: 10.1186/1472-6874-11-40
Source: PubMed


While there is extensive literature evaluating the impact of phytoestrogen consumption on breast cancer risk, its role on ovarian cancer has received little attention.
We conducted a population-based case-control study to evaluate phytoestrogen intake from foods and supplements and epithelial ovarian cancer risk. Cases were identified in six counties in New Jersey through the New Jersey State Cancer Registry. Controls were identified by random digit dialing, CMS (Centers for Medicare and Medicaid Service) lists, and area sampling. A total of 205 cases and 390 controls were included in analyses. Unconditional logistic regression analyses were conducted to examine associations with total phytoestrogens, as well as isoflavones (daidzein, genistein, formononetin, and glycitein), lignans (matairesinol, lariciresinol, pinoresinol, secoisolariciresinol), and coumestrol.
No statistically significant associations were found with any of the phytoestrogens under evaluation. However, there was a suggestion of an inverse association with total phytoestrogen consumption (from foods and supplements), with an odds ratio (OR) of 0.62 (95% CI: 0.38-1.00; p for trend: 0.04) for the highest vs. lowest tertile of consumption, after adjusting for reproductive covariates, age, race, education, BMI, and total energy. Further adjustment for smoking and physical activity attenuated risk estimates (OR: 0.66; 95% CI: 0.41-1.08). There was little evidence of an inverse association for isoflavones, lignans, or coumestrol.
This study provided some suggestion that phytoestrogen consumption may decrease ovarian cancer risk, although results did not reach statistical significance.

Download full-text


Available from: Lorna Rodríguez-Rodríguez, Oct 08, 2015
29 Reads
  • Source
    • "Key clinical, demographic, and questionnaire data were harmonized across study centers and merged into a common dataset. Dietary intakes of folate and total energy were estimated with validated food frequency questionnaire in six studies (AUS [36], DOV [37], HAW and STA [38], NEC [39], and NJO [40]) pertaining to the year preceding recruitment or for the time period approximately 4 years before the reference date (DOV). Data on the use of multivitamins and single vitamin and mineral supplements were also available and total folate intake was estimated by summing intakes from both food sources and from supplements. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Scope: We reevaluated previously reported associations between variants in pathways of one-carbon (1-C) (folate) transfer genes and ovarian carcinoma (OC) risk, and in related pathways of purine and pyrimidine metabolism, and assessed interactions with folate intake. Methods and results: Odds ratios (OR) for 446 genetic variants were estimated among 13,410 OC cases and 22,635 controls, and among 2281 cases and 3444 controls with folate information. Following multiple testing correction, the most significant main effect associations were for dihydropyrimidine dehydrogenase (DPYD) variants rs11587873 (OR = 0.92; p = 6 × 10⁻⁵) and rs828054 (OR = 1.06; p = 1 × 10⁻⁴). Thirteen variants in the pyrimidine metabolism genes, DPYD, DPYS, PPAT, and TYMS, also interacted significantly with folate in a multivariant analysis (corrected p = 9.9 × 10⁻⁶) but collectively explained only 0.2% of OC risk. Although no other associations were significant after multiple testing correction, variants in SHMT1 in 1-C transfer, previously reported with OC, suggested lower risk at higher folate (p(interaction) = 0.03-0.006). Conclusion: Variation in pyrimidine metabolism genes, particularly DPYD, which was previously reported to be associated with OC, may influence risk; however, stratification by folate intake is unlikely to modify disease risk appreciably in these women. SHMT1 SNP-by-folate interactions are plausible but require further validation. Polymorphisms in selected genes in purine metabolism were not associated with OC.
    Molecular Nutrition & Food Research 07/2014; 58(10). DOI:10.1002/mnfr.201400068 · 4.60 Impact Factor
  • Source
    • "Gastric Sweden Protective effects of quercetin in female smokers Ekstrom et al., 2011 (18) Pancreatic Northern Italy Reduced cancer risk with higher intake of proanthocyanidins Rossi et al., 2011 (21) Colorectal Japan Protective effects of isoflavones in men and postmenopausal women Budhathoki et al., 2011 (25) Japan Reduced risk with higher isoflavones intake Akhter et al., 2009 (26) Italy Protective effects of proantocyanidins except for monomer cyanidins Rossi et al., 2010 (11) Italy Reduced risk with increased intake of isoflavones, flavones, and flavonols Rossi et al., 2006 (27) UK Reduced risk with non-tea flavonols (quercetin) Kyle et al., 2010 (28) Liver Greece Reduced risk with increased intake of flavones Lagiou et al., 2008 (39) Reproductive Prostate Scotland Reduced risk with higher intake of soy foods Heald et al., 2007 (42) Prostate Italy No association with flavonoids intake Bosetti et al., 2006 (43) Prostate Jamaica Reduced risk associated with higher levels of equol in urine Jackson et al., 2010 (167) Ovarian New Jersey No association with isoflavones intake Bandera et al., 2011 (57) Ovarian U.S. Weak support for protection by apigenin Gates et al., 2009 (58) Ovarian Italy Reduced risk with flavonols and isoflavones Rossi et al., 2008 (60) Endometrial New Jersey Reduced risk with higher dietary intake of total isoflavones in lean women (BMI <25) and quercetin Bandera et al., 2009 (62). Breast China Protective effects of isoflavones in pre-and postmenopausal women Wang et al., 2011 (63) (Continued ) Flavonoids and Cancer Prevention 209 for flavanones; and 0.62 and 0.32 for flavonols) (11) (Table 2). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this work is to review data from epidemiological and preclinical studies addressing the potential benefits of diets based on flavonoids for cancer prevention. Flavonoids are subdivided into subclasses including flavonols, flavones, flavanones, flavan-3-ols, anthocyanidins, and isoflavones. Epidemiological studies suggest dietary intake of flavonoids may reduce the risk of tumors of the breast, colon, lung, prostate, and pancreas. However, some studies have reported inconclusive or even harmful associations. A major challenge in the interpretation of epidemiological studies is that most of the data originate from case-control studies and retrospective acquisition of flavonoid intake. Differences in agricultural, sociodemographics, and lifestyle factors contribute to the heterogeneity in the intake of flavonoids among populations residing in the United States, Europe, and Asia. Dose and timing of exposure may influence the anticancer response to flavonoid-rich diets. A limited number of intervention trials of flavonoids have documented cancer preventative effects. Proposed anticancer mechanisms for flavonoids are inhibition of proliferation, inflammation, invasion, metastasis, and activation of apoptosis. Prospective studies with larger sample sizes are needed to develop biomarkers of flavonoid intake and effect. Mechanistic studies are needed to ascertain how flavonoid-rich diets influence gene regulation for cancer prevention.
    Journal of Nutrition in Gerontology and Geriatrics 07/2012; 31(3):206-38. DOI:10.1080/21551197.2012.702534
  • Source
    • "We therefore sought to investigate the association between total antioxidant capacity (TAC) intake and ovarian cancer risk using data from standardized antioxidant databases in a population-based case–control study conducted in New Jersey [9,10]. As few studies have investigated the role of antioxidant supplement intake and ovarian cancer risk, and evidence on individual dietary antioxidants is inconclusive, we also investigated the association between individual antioxidant micronutrients from food and supplements with ovarian cancer risk. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Limiting oxidative stress to the ovarian epithelium has been proposed as a first-line defense against ovarian cancer. Although evidence for an association between individual dietary antioxidant intake and ovarian cancer risk is conflicting, the combined evidence suggests a modest inverse association. Our study aimed to evaluate the association between total antioxidant capacity (TAC) and individual antioxidant intakes (vitamin C, vitamin E, beta-carotene, selenium, lutein, and lycopene) and ovarian cancer risk. We conducted a population-based case-control study in New Jersey. Cases were women ages 21 years and older with newly diagnosed epithelial ovarian cancer who resided in six counties of New Jersey. Controls were women in the same age range who resided in the same geographic area. A total of 205 ovarian cancer cases and 390 controls were included. Dietary intake was ascertained using the Block food frequency questionnaire (FFQ), and TAC indices were constructed by linking FFQ-derived estimates to two standardized antioxidant capacity databases, the USDA Oxygen Radical Absorbance Capacity (ORAC) Database, and the University of Olso's Antioxidant Food Database. Multivariate logistic regression models were used to calculate odds ratios and 95 % confidence intervals while controlling for major ovarian cancer risk factors. We found a strong inverse association with selenium from food sources (OR: 0.41; 95 % CI: 0.20-0.85, for the highest vs. lowest tertile of dietary selenium intake). However, there was little evidence of an association with dietary TAC or the others individual antioxidants. In contrast, compared to non-users, supplement users had significant increased risk for all micronutrients, but no statistically significant increased risk was observed for combined intake from foods and supplements of any of these antioxidants. This study found an inverse association between selenium consumption from food sources and ovarian cancer risk, while there was little evidence of an association with TAC or any of the other individual antioxidants. Additional research is needed to confirm these findings.
    BMC Cancer 06/2012; 12(1):211. DOI:10.1186/1471-2407-12-211 · 3.36 Impact Factor
Show more