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Flavonoids and Colorectal Cancer in Italy

¹ Istituto di Ricerche Farmacologiche "Mario Negri"; ² Divisione di Epidemiologia e Biostatistica, Istituto Europeo di Oncologia; ³ Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milan, Italy; ⁴ Unità di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano (PN), Italy; ⁵ Istituto di Igiene ed Epidemiologia, Universita' degli Studi di Udine, Udine, Italy; ⁶ IARC, Lyon, France; ⁷ Servizio di Epidemiologia, Istituto Tumori "Fondazione Pascale," Naples, Italy; and ⁸ Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy

Requests for reprints: Marta Rossi, Istituto di Ricerche Farmacologiche "Mario Negri," Via Eritrea 62, 20157 Milan, Italy. Phone: 39-0239014541; Fax: 39-0233200231. E-mail: mrossi{at}marionegri.it

Because of their several biological activities, flavonoids may have an important role in explaining the protective effects of vegetables, fruit, and, possibly, tea against cancer. The potential relation between flavonoids and colorectal cancer risk was investigated using data from a multicentric Italian case-control study, including 1,953 cases of colorectal cancers (1,225 colon cancers and 728 rectal cancers) and 4,154 hospital controls admitted for acute nonneoplastic diseases. We have applied recently published data on the composition of foods and beverages, in terms of six principal classes of flavonoids, on dietary information collected through a validated food-frequency questionnaire. Odds ratios (OR) were estimated by multiple logistic regression models, including terms for sex, age, study center, family history of colorectal cancer, education, alcohol consumption, body mass index, physical activity, and energy intake. A reduced risk of colorectal cancer was found for increasing intake of isoflavones (OR, 0.76, for the highest versus the lowest quintile, P_trend = 0.001), anthocyanidins (OR, 0.67, P_trend < 0.001), flavones (OR, 0.78, P_trend = 0.004), and flavonols (OR, 0.64, P_trend < 0.001). No significant association was found for flavan-3-ols (OR, 0.98), flavanones (OR, 0.96), and total flavonoids (OR, 0.97). The estimates did not substantially differ for colon and rectal cancers, as well as in strata of sex, age, and body mass index. The findings of this large study provide support for an inverse association of selected classes of flavonoids with colorectal cancer risk. (Cancer Epidemiol Biomarker Prev 2006;15(8):1555–8)

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