Dietary flavonoid intake and risk of stomach and colorectal cancer

Table 1 Selected studies on dietary flavonoids and risk of stomach and colorectal cancer

Ref.	Cancer site	Country	Study period	Case/control (n/n)	Dietary assessment method	Reported flavonoids	Included subclasses for total flavonoids	Intake comparison High vs low (mg/d)1	Controlled confounders
Garcia-Closas et al[20]	Stomach	Spain	1987-1989	354/354	Diet history	Q, K, M		Q4 vs Q1 mean (SD), Q: 7.1 (6.5), K: 1.2 (1.9), M: 0.65 (1.17)	Total energy intake, intake of nitrites, nitrosamines, vitamin C, total carotenoids (α-carotene, β-carotene, lutein, and lycopene) and other specific favonoids (quercetin, kaempferol, myricetin, and luteolin)
Lagiou et al[21]	Stomach	Greece	1981-1984	110/100	FFQ	F1, F2, F3, F4, An, I		F1: per 10.0, F2: per 0.3, F3: per 19.8, F4: per 135.1, An: per 40.4, I: per 2.0.	Age, gender, total energy intake, place of birth, BMI, height, years of education, smoking habits and duration of smoking, alcohol consumption, and fruit and vegetable consumption
Cotterchio et al[22]	Colorectum	Canada	1997-2000	1095/1890	FFQ	I		> 1.097 vs < 0.289.	Age, sex, and total energy intake
Rossi et al[23]	Colorectum	Italy	1992-1996	1953/4154	FFQ	T, F1, F2, F3, F4, An, I	F1, F2, F3, F4, An, I	T: > 191.1 vs < 75.3, F1: > 28.5 vs < 13.2, F2: > 0.7 vs < 0.3, F3: > 67.0 vs < 12.5, F4: > 88.5 vs < 20.8, An: > 31.7 vs < 5.3, I: > 33.9 vs < 14.4	Age, sex, energy intake, study center, family history of colorectal cancer, education, alcohol consumption, BMI, and occupational physical activity
Theodoratou et al[24]	Colorectum	Scotland	-	1456/1456	FFQ	F1, F2, F3, F4, Q, H, N, C, E		F1: > 36.75 vs < 16, F2: > 1.9 vs < 0.5, F3: > 45.2 vs < 16.7, F4: > 162.1 vs < 42.6, Q: > 22.9 vs < 11.7, H: > 21.1 vs < 3.95, N: > 19.7 vs < 3.8	Total energy intake, family history of colorectal cancer, total fiber intake, alcohol intake, NSAID intake, smoking, BMI, physical activity, and fruit and vegetable intake
Akhter et al[25]	Colorectum	Japan	2004-2005	721/697	FFQ	I		> 62.41 vs < 24.77	Age, sex, total energy intake, screening period, family history of colorectal cancer, cigarette smoking, alcohol consumption, BMI, physical activity, supplement use and non-steroidal anti-inflammatory drug use
Kyle et al[26]	Colorectum	United Kingdom	1998-2000	261/404	FFQ	F1, F3, F4		F1: > 40.4 vs < 19.3, F3: > 32.2 vs < 2.73, F4: > 188.8 vs < 67.1	Age, energy, family history, non-steroidal anti-inflammatory drugs, aspirin, Mn, riboflavin, vitamin C, folate
Rossi et al[27]	Stomach	Italy	1997-2007	230/547	FFQ	F1, F2, F3, F4, An, I, P		F1: > 32.3 vs < 13.2, F2: > 0.7 vs < 0.3, F3: > 56.8 vs < 12.9, F4: > 79.2 vs < 21.6, An: > 21.5 vs < 6.2, I: > 34.3 vs < 15.0, P: > 373.0 vs < 339.6	Age, sex, education, year of interview, BMI, tobacco smoking, and total energy intake
Rossi et al[28]	Colorectum	Italy	1992-1996	1953/4154	FFQ	P		> 486.6 vs < 202.5	Age, sex, study center, family history, education, alcohol consumption, BMI, physical activity and energy intake
Budhathoki et al[29]	Colorectum	Japan	2003-2003	816/815	FFQ	I		74.4 vs 15.5 (median)	Age, sex, total energy intake, resident area, parental colorectal cancer, smoking, alcohol use, BMI, type of job, and leisure time physical activity
Ekström et al[30]	Stomach (cardia and non cardia)	Sweden	1989-1995	C81, Non; 420 /1116	FFQ	Q		> 11.89 vs < 3.88	Age, sex, socioeconomic status, number of siblings, BMI, smoking and energy and salt intake
Zamora-Ros et al[31]	Colorectum	Spain	1996-1998	424/401	FFQ	T, F1, F2, F3, F4, An, I, P	F1, F2, F3, F4, An, I, P, Th	T: > 167.9 vs < 68.9, F1: > 11.5 vs < 5.1, F2: > 2.1 vs < 0.7, F3: > 17.7 vs < 3.7, F4: > 12.9 vs < 4.9, An: > 10.6 vs < 3.3, I: > 0.17 vs < 0.07, P: > 112.3 vs < 40.9	Age, sex, energy intake, BMI, alcohol and fiber intake, red and processed meat intake, tobacco consumption, physical activity, regular drugs, and family history of colorectal cancer
Djuric et al[32]	Colorectum	United States	2003-2005	1163/1501	FFQ	Q		> 10.29 vs < 4.33	Age, sex, physical activity at age 30-39, BMI, family history of colorectal cancer, highest education achieved, and nonsteroidal antiinflammatory drug use (NSAID) use, red meat, and total calcium intake
			Follow-up (yr)	Case (n)
Hirvonen [33]	Colorectum, Stomach	Finland	6.1 (median)	C 133S 111	Diet history	T	F1, F2	16.3 vs 4.2 (median)	Age and supplementation group
Knekt et al[34]	Colorectum, Stomach	Finland	30 (maximum)	C 90S 74	Diet history	T, Q, K, M, H, N	F1, F2, F3	T: > 39.5 (F), 26.9 (M) vs < 8.5 (F), 4.3 (M), Q: > 4.7 (F), 3.9 (M) vs < 1.8 (F), 1.5 (M), K: > 0.9 (F), 0.8 (M) vs < 0.2 (F), 0.1 (M), M: > 0.2 (F), 0.11 (M) vs < 0.03 (F), 0.06 (M), H:> 26.8 (F), 15.4 (M) vs < 3.2 (F), 0 (M), N: > 7.7 (F), 4.7 (M) vs < 0.9 (F), 0 (M)	Age, sex, geographic area, occupation, smoking, and BMI
Lin et al[35]	Colorectum	United States	-	878	FFQ	T, Q, K, M	F1, F2	Q5 vs Q1 (NHS: > 31.1 vs < 9.6, HPFS: > 30.5 vs < 10.7)	Age, BMI, family history of colorectal cancer, history of colorectal polyps, prior sigmoidoscopy screening, physical activity, smoking status, red meat intake, alcohol consumption, total energy intake, total calcium intake, total folate intake, total fiber intake, aspirin use, and multivitamin use
Akhter et al[36]	Colorectum	Japan	7.6 (mean)	886	FFQ	I		Q4 vs Q1	Age, public health center area, history of diabetes mellitus, BMI, leisure time physical activity, cigarette smoking, alcohol drinking, and intake of vitamin D, dairy products, meat, fruit, vegetable, and fish, (F) + menopausal status and current use of female hormones
Mursu et al[37]	Colorectum	Finland	16.2 (mean)	55	Food recording	T, F1, F2, F3, F4, An	F1, F2, F3, F4, An	Q4 vs Q1T: 416.3 vs 265.0 (mean)	Age and examination years, BMI, smoking status, pack-years of smoking, physical activity, intakes of alcohol, total fat and saturated fat, and energy adjusted intake of fiber, vitamin C and E
Simon et al[38]	Colorectum	Netherlands	13.3	1271	FFQ	T, F4	F1, F2	T: > 36 vs < 16 (M), F4: > 84.3 vs < 44.4 (M), T: > 38.3 vs < 18.4 (F), F4: > 95.9 vs < 51.6 (F)	Age, family history of colorectal cancer, smoking status, alcohol intake, occupational physical activity at longest held job, BMI and processed meat intake
Ward et al[41]	Colorectum	Unitd States	9 (mean)	221	Food recording	I		Continuous	Age, height, weight, family history of colorectal cancer, smoking status, aspirin use, physical activity, and average daily intake of fat, energy, calcium, alcohol, and red and processed meats, (F) + oral contraceptive use, menopausal status, menopausal hormone therapy use, parity, breastfeeding, and surgical removal of ovaries
Hara et al[42]	Stomach	Japan		1249	FFQ	I		Q4 vs Q1 (median), 42.3 vs 9.2 (M), 41.8 vs 9.4 (F)	Age, public center area, BMI, smoking status, ethanol intake, family history of gastric cancer, vegetable, fruit, fish, salt, and total energy intake

¹M and F represent male and female in this row. Q: Querectin; K: Kaempferol; M: Myricetin; H: Hesperidin; N: Naringenin; C: Catechin; E: Epicatechin; F1: Flavonols; F2: Flavones; F3: Flavanones; F4: Flavan-3-ols; An: Anthocyanidins; I: Isoflavones; P: Proanthocyanidins; Th: Theaflavins; BMI: Body mass index.