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Dietary intake of total polyphenol and polyphenol classes and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.
Eur J Epidemiol 2018; 33(11):1063-1075EJ

Abstract

Polyphenols may play a chemopreventive role in colorectal cancer (CRC); however, epidemiological evidence supporting a role for intake of individual polyphenol classes, other than flavonoids is insufficient. We evaluated the association between dietary intakes of total and individual classes and subclasses of polyphenols and CRC risk and its main subsites, colon and rectum, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The cohort included 476,160 men and women from 10 European countries. During a mean follow-up of 14 years, there were 5991 incident CRC cases, of which 3897 were in the colon and 2094 were in the rectum. Polyphenol intake was estimated using validated centre/country specific dietary questionnaires and the Phenol-Explorer database. In multivariable-adjusted Cox regression models, a doubling in total dietary polyphenol intake was not associated with CRC risk in women (HRlog2 = 1.06, 95% CI 0.99-1.14) or in men (HRlog2 = 0.97, 95% CI 0.90-1.05), respectively. Phenolic acid intake, highly correlated with coffee consumption, was inversely associated with colon cancer in men (HRlog2 = 0.91, 95% CI 0.85-0.97) and positively associated with rectal cancer in women (HRlog2 = 1.10, 95% CI 1.02-1.19); although associations did not exceed the Bonferroni threshold for significance. Intake of other polyphenol classes was not related to colorectal, colon or rectal cancer risks. Our study suggests a possible inverse association between phenolic acid intake and colon cancer risk in men and positive with rectal cancer risk in women.

Authors+Show Affiliations

Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Av Gran Via 199-203, 08908, L'Hospitalet De Llobregat, Barcelona, Spain. rzamora@iconcologia.net.Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Av Gran Via 199-203, 08908, L'Hospitalet De Llobregat, Barcelona, Spain.Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France.Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France.Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA, USA.Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.Danish Cancer Society Research Center, Copenhagen, Denmark.Danish Cancer Society Research Center, Copenhagen, Denmark.Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France. Institut Gustave Roussy, Villejuif, France.CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France. Institut Gustave Roussy, Villejuif, France. Department of Gastroenterology, Bicêtre University Hospital, Assistance Publique des Hôpitaux de Paris, Le Kremlin Bicêtre, France.CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France. Institut Gustave Roussy, Villejuif, France.Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.Hellenic Health Foundation, Athens, Greece. WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.Hellenic Health Foundation, Athens, Greece.Hellenic Health Foundation, Athens, Greece. WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy.Cancer Registry and Histopathology Unit, "Civic M.P. Arezzo" Hospital, ASP Ragusa, Italy.Department of Clinical and Biological Sciences, University of Turin, Turin, Italy. Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco (TO), Italy.Department of Community Medicine, Faculty of Health Sciences, UiT, The Artic University of Tromsø, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Genetic Epidemiology Group, Folkhälsan Research Center and Faculty of Medicine, University of Helsinki, Helsinki, Finland.Department of Community Medicine, Faculty of Health Sciences, UiT, The Artic University of Tromsø, Tromsø, Norway.Department of Community Medicine, Faculty of Health Sciences, UiT, The Artic University of Tromsø, Tromsø, Norway.Department of Functional Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain.Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Av Gran Via 199-203, 08908, L'Hospitalet De Llobregat, Barcelona, Spain.Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.Granada. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain.CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain.CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Navarra Public Health Institute, Pamplona, Spain. IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden.Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden.Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands. Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK. Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.Cancer Epidemiology Unit, University of Oxford, Oxford, UK.Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France.Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France.Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29761424

Citation

Zamora-Ros, Raul, et al. "Dietary Intake of Total Polyphenol and Polyphenol Classes and the Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC) Cohort." European Journal of Epidemiology, vol. 33, no. 11, 2018, pp. 1063-1075.
Zamora-Ros R, Cayssials V, Jenab M, et al. Dietary intake of total polyphenol and polyphenol classes and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Eur J Epidemiol. 2018;33(11):1063-1075.
Zamora-Ros, R., Cayssials, V., Jenab, M., Rothwell, J. A., Fedirko, V., Aleksandrova, K., ... Scalbert, A. (2018). Dietary intake of total polyphenol and polyphenol classes and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. European Journal of Epidemiology, 33(11), pp. 1063-1075. doi:10.1007/s10654-018-0408-6.
Zamora-Ros R, et al. Dietary Intake of Total Polyphenol and Polyphenol Classes and the Risk of Colorectal Cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC) Cohort. Eur J Epidemiol. 2018;33(11):1063-1075. PubMed PMID: 29761424.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary intake of total polyphenol and polyphenol classes and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. AU - Zamora-Ros,Raul, AU - Cayssials,Valerie, AU - Jenab,Mazda, AU - Rothwell,Joseph A, AU - Fedirko,Veronika, AU - Aleksandrova,Krasimira, AU - Tjønneland,Anne, AU - Kyrø,Cecilie, AU - Overvad,Kim, AU - Boutron-Ruault,Marie-Christine, AU - Carbonnel,Franck, AU - Mahamat-Saleh,Yahya, AU - Kaaks,Rudolf, AU - Kühn,Tilman, AU - Boeing,Heiner, AU - Trichopoulou,Antonia, AU - Valanou,Elissavet, AU - Vasilopoulou,Effie, AU - Masala,Giovanna, AU - Pala,Valeria, AU - Panico,Salvatore, AU - Tumino,Rosario, AU - Ricceri,Fulvio, AU - Weiderpass,Elisabete, AU - Lukic,Marko, AU - Sandanger,Torkjel M, AU - Lasheras,Cristina, AU - Agudo,Antonio, AU - Sánchez,Maria-Jose, AU - Amiano,Pilar, AU - Navarro,Carmen, AU - Ardanaz,Eva, AU - Sonestedt,Emily, AU - Ohlsson,Bodil, AU - Nilsson,Lena Maria, AU - Rutegård,Martin, AU - Bueno-de-Mesquita,Bas, AU - Peeters,Petra H, AU - Khaw,Kay-Thee, AU - Wareham,Nicholas J, AU - Bradbury,Kathryn, AU - Freisling,Heinz, AU - Romieu,Isabelle, AU - Cross,Amanda J, AU - Vineis,Paolo, AU - Scalbert,Augustin, Y1 - 2018/05/15/ PY - 2017/12/14/received PY - 2018/05/04/accepted PY - 2018/5/16/pubmed PY - 2019/4/23/medline PY - 2018/5/16/entrez KW - Colorectal cancer KW - Diet KW - EPIC KW - Intake KW - Polyphenols KW - Prospective cohort SP - 1063 EP - 1075 JF - European journal of epidemiology JO - Eur. J. Epidemiol. VL - 33 IS - 11 N2 - Polyphenols may play a chemopreventive role in colorectal cancer (CRC); however, epidemiological evidence supporting a role for intake of individual polyphenol classes, other than flavonoids is insufficient. We evaluated the association between dietary intakes of total and individual classes and subclasses of polyphenols and CRC risk and its main subsites, colon and rectum, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The cohort included 476,160 men and women from 10 European countries. During a mean follow-up of 14 years, there were 5991 incident CRC cases, of which 3897 were in the colon and 2094 were in the rectum. Polyphenol intake was estimated using validated centre/country specific dietary questionnaires and the Phenol-Explorer database. In multivariable-adjusted Cox regression models, a doubling in total dietary polyphenol intake was not associated with CRC risk in women (HRlog2 = 1.06, 95% CI 0.99-1.14) or in men (HRlog2 = 0.97, 95% CI 0.90-1.05), respectively. Phenolic acid intake, highly correlated with coffee consumption, was inversely associated with colon cancer in men (HRlog2 = 0.91, 95% CI 0.85-0.97) and positively associated with rectal cancer in women (HRlog2 = 1.10, 95% CI 1.02-1.19); although associations did not exceed the Bonferroni threshold for significance. Intake of other polyphenol classes was not related to colorectal, colon or rectal cancer risks. Our study suggests a possible inverse association between phenolic acid intake and colon cancer risk in men and positive with rectal cancer risk in women. SN - 1573-7284 UR - https://www.unboundmedicine.com/medline/citation/29761424/Dietary_intake_of_total_polyphenol_and_polyphenol_classes_and_the_risk_of_colorectal_cancer_in_the_European_Prospective_Investigation_into_Cancer_and_Nutrition__EPIC__cohort_ L2 - https://doi.org/10.1007/s10654-018-0408-6 DB - PRIME DP - Unbound Medicine ER -