Dietary Flavonols Intake and Risk of Esophageal and Gastric Cancer: A Meta-Analysis of Epidemiological Studies

Overview

Journal Nutrients

Date 2016 Feb 19

PMID 26891324

Citations 13

Authors

Yan Xie

Shifeng Huang

Yuxi Su

Affiliations

Soon will be listed here.

Abstract

Background: Esophageal cancer (EC) and gastric cancer (GC) are common cancers and leading causes of cancer deaths worldwide. Many studies have investigated the association between dietary flavonols intake and the risk of EC and GC, but the results are inconsistent. Hence, we conducted a systematic analysis of relevant population-based studies to assess the association and derive a more precise estimation.

Methods: The Cochrane, PubMed and Embase databases were searched to identify articles published through January 2016 that met the predetermined inclusion criterion. Twelve studies involving 4593 patients and 519,378 controls were included.

Results: The summary odds ratios (ORs) of EC, GC and the two combined were respectively 0.88 (95% CI: 0.73-1.08), 0.80 (95% CI: 0.70-0.91) and 0.83 (95% CI: 0.74-0.92) for the highest category of dietary flavonols intake compared with the lowest. No significant heterogeneities were observed in these studies. Further analysis showed that the pooled ORs of EC and GC for cohort, population-based case-control and hospital-based case-control studies were 0.90 (95% CI: 0.61-1.34), 0.92 (95% CI: 0.72-1.18), 0.68 (95% CI: 0.38-1.24) and 0.83 (95% CI: 0.65-1.06), 0.84 (95% CI: 0.45-1.59), 0.70 (95% CI: 0.56-0.88). The subgroup analyses revealed a significant association of flavonol intake with a reduced risk of noncardia gastric adenocarcinoma but not gastric cardia adenocarcinoma. Moreover, significant inverse associations of flavonol intake with GC risk were observed in women but not in men, in smokers but not in nonsmokers, in European populations but not in American populations. Similarly, a significant inverse association of flavonols intake with EC risk was also observed in smokers but not in nonsmokers.

Conclusion: High intake of dietary flavonols is significantly related to a reduced risk of GC, especially in women and smokers.

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References

Ekstrom A, Serafini M, Nyren O, Wolk A, Bosetti C, Bellocco R . Dietary quercetin intake and risk of gastric cancer: results from a population-based study in Sweden. Ann Oncol. 2010; 22(2):438-43. PMC: 3030468. DOI: 10.1093/annonc/mdq390. View

Vermeulen E, Zamora-Ros R, Duell E, Lujan-Barroso L, Boeing H, Aleksandrova K . Dietary flavonoid intake and esophageal cancer risk in the European prospective investigation into cancer and nutrition cohort. Am J Epidemiol. 2013; 178(4):570-81. DOI: 10.1093/aje/kwt026. View

Touvier M, Druesne-Pecollo N, Kesse-Guyot E, Andreeva V, Fezeu L, Galan P . Dual association between polyphenol intake and breast cancer risk according to alcohol consumption level: a prospective cohort study. Breast Cancer Res Treat. 2012; 137(1):225-36. DOI: 10.1007/s10549-012-2323-y. View

Woo H, Kim J . Dietary flavonoid intake and risk of stomach and colorectal cancer. World J Gastroenterol. 2013; 19(7):1011-9. PMC: 3581988. DOI: 10.3748/wjg.v19.i7.1011. View

Men K, Duan X, Wei X, Gou M, Huang M, Chen L . Nanoparticle-delivered quercetin for cancer therapy. Anticancer Agents Med Chem. 2014; 14(6):826-32. DOI: 10.2174/1871520614666140521122932. View

Tseng H, Li C, Huang L, Chen C, Tsai C, Lin C . Quercetin 3-O-methyl ether protects FL83B cells from copper induced oxidative stress through the PI3K/Akt and MAPK/Erk pathway. Toxicol Appl Pharmacol. 2012; 264(1):104-13. DOI: 10.1016/j.taap.2012.07.022. View

Li G, WuLan H, Song Z, Paik P, Tsao M, Goodman G . Regulatory B Cell Function Is Suppressed by Smoking and Obesity in H. pylori-Infected Subjects and Is Correlated with Elevated Risk of Gastric Cancer. PLoS One. 2015; 10(7):e0134591. PMC: 4520600. DOI: 10.1371/journal.pone.0134591. View

Bobe G, Peterson J, Gridley G, Hyer M, Dwyer J, Brown L . Flavonoid consumption and esophageal cancer among black and white men in the United States. Int J Cancer. 2009; 125(5):1147-54. PMC: 7251636. DOI: 10.1002/ijc.24421. View

Lu Q, Ji X, Zhou Y, Yao X, Liu Y, Zhang F . Quercetin inhibits the mTORC1/p70S6K signaling-mediated renal tubular epithelial-mesenchymal transition and renal fibrosis in diabetic nephropathy. Pharmacol Res. 2015; 99:237-47. DOI: 10.1016/j.phrs.2015.06.006. View

10.

Fitzmaurice C, Dicker D, Pain A, Hamavid H, Moradi-Lakeh M, MacIntyre M . The Global Burden of Cancer 2013. JAMA Oncol. 2015; 1(4):505-27. PMC: 4500822. DOI: 10.1001/jamaoncol.2015.0735. View

11.

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

12.

Hui C, Qi X, Qianyong Z, Xiaoli P, Jundong Z, Mantian M . Flavonoids, flavonoid subclasses and breast cancer risk: a meta-analysis of epidemiologic studies. PLoS One. 2013; 8(1):e54318. PMC: 3548848. DOI: 10.1371/journal.pone.0054318. View

13.

Miyamoto N, Izumi H, Miyamoto R, Kondo H, Tawara A, Sasaguri Y . Quercetin induces the expression of peroxiredoxins 3 and 5 via the Nrf2/NRF1 transcription pathway. Invest Ophthalmol Vis Sci. 2010; 52(2):1055-63. DOI: 10.1167/iovs.10-5777. View

14.

Greenland S . Quantitative methods in the review of epidemiologic literature. Epidemiol Rev. 1987; 9:1-30. DOI: 10.1093/oxfordjournals.epirev.a036298. View

15.

Rossi M, Rosato V, Bosetti C, Lagiou P, Parpinel M, Bertuccio P . Flavonoids, proanthocyanidins, and the risk of stomach cancer. Cancer Causes Control. 2010; 21(10):1597-604. DOI: 10.1007/s10552-010-9588-4. View

16.

Liu Y, Wu Y, Zhang P . Protective effects of curcumin and quercetin during benzo(a)pyrene induced lung carcinogenesis in mice. Eur Rev Med Pharmacol Sci. 2015; 19(9):1736-43. View

17.

Rossi M, Garavello W, Talamini R, La Vecchia C, Franceschi S, Lagiou P . Flavonoids and risk of squamous cell esophageal cancer. Int J Cancer. 2006; 120(7):1560-4. DOI: 10.1002/ijc.22499. View

18.

Knekt P, Kumpulainen J, Jarvinen R, Rissanen H, Heliovaara M, Reunanen A . Flavonoid intake and risk of chronic diseases. Am J Clin Nutr. 2002; 76(3):560-8. DOI: 10.1093/ajcn/76.3.560. View

19.

Woo H, Lee J, Choi I, Kim C, Lee J, Kwon O . Dietary flavonoids and gastric cancer risk in a Korean population. Nutrients. 2014; 6(11):4961-73. PMC: 4245574. DOI: 10.3390/nu6114961. View

20.

De Stefani E, Ronco A, Mendilaharsu M, Deneo-Pellegrini H . Diet and risk of cancer of the upper aerodigestive tract--II. Nutrients. Oral Oncol. 1999; 35(1):22-6. DOI: 10.1016/s1368-8375(98)00061-x. View