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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

Zamora-Ros R 1 , Cayssials V 2 , Jenab M 3 , Rothwell JA 3 , Fedirko V 4 , Aleksandrova K 5 Show all authors , Tjønneland A 6 , Kyrø C 6 , Overvad K 7 , Boutron-Ruault MC 8 , Carbonnel F 8 , Mahamat-Saleh Y 8 , Kaaks R 9 , Kühn T 9 , Boeing H 5 , Trichopoulou A 10 , Valanou E 10 , Vasilopoulou E 10 , Masala G 11 , Pala V 12 , Panico S 13 , Tumino R 14 , Ricceri F 15 , Weiderpass E 16 , Lukic M 16 , Sandanger TM 16 , Lasheras C 17 , Agudo A 2 , Sánchez MJ 18 , Amiano P 19 , Navarro C 19 , Ardanaz E 19 , Sonestedt E 20 , Ohlsson B 21 , Nilsson LM 22 , Rutegård M 23 , Bueno-de-Mesquita B 24 , Peeters PH 25 , Khaw KT 26 , Wareham NJ 27 , Bradbury K 28 , Freisling H 3 , Romieu I 3 , Cross AJ 25 , Vineis P 25 , Scalbert A 3

Affiliations 

  • 1 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
  • 2 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
  • 3 Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
  • 4 Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA, USA
  • 5 Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  • 6 Danish Cancer Society Research Center, Copenhagen, Denmark
  • 7 Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
  • 8 CESP (Centre de Recherche en Epidémiologie et Santé des Populations), Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
  • 9 Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
  • 10 Hellenic Health Foundation, Athens, Greece
  • 11 Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
  • 12 Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • 13 Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy
  • 14 Cancer Registry and Histopathology Unit, "Civic M.P. Arezzo" Hospital, ASP Ragusa, Italy
  • 15 Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
  • 16 Department of Community Medicine, Faculty of Health Sciences, UiT, The Artic University of Tromsø, Tromsø, Norway
  • 17 Department of Functional Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain
  • 18 Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.Granada. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
  • 19 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
  • 20 Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
  • 21 Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
  • 22 Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
  • 23 Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
  • 24 Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
  • 25 Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK
  • 26 Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
  • 27 MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
  • 28 Cancer Epidemiology Unit, University of Oxford, Oxford, UK
Eur J Epidemiol, 2018 Nov;33(11):1063-1075.
PMID: 29761424 DOI: 10.1007/s10654-018-0408-6

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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