Abstract
BackgroundPrevious studies have indicated that intake of dietary flavonoids or flavonoid subclasses is associated with the ovarian cancer risk, but presented controversial results. Therefore, we conducted a meta-analysis to derive a more precise estimation of these associations.MethodsWe performed a search in PubMed, Google Scholar and ISI Web of Science from their inception to April 25, 2015 to select studies on the association among dietary flavonoids, flavonoid subclasses and ovarian cancer risk. The information was extracted by two independent authors. We assessed the heterogeneity, sensitivity, publication bias and quality of the articles. A random-effects model was used to calculate the pooled risk estimates.ResultsFive cohort studies and seven case-control studies were included in the final meta-analysis. We observed that intake of dietary flavonoids can decrease ovarian cancer risk, which was demonstrated by pooled RR (RR = 0.82, 95% CI = 0.68–0.98). In a subgroup analysis by flavonoid subtypes, the ovarian cancer risk was also decreased for isoflavones (RR = 0.67, 95% CI = 0.50–0.92) and flavonols (RR = 0.68, 95% CI = 0.58–0.80). While there was no compelling evidence that consumption of flavones (RR = 0.86, 95% CI = 0.71–1.03) could decrease ovarian cancer risk, which revealed part sources of heterogeneity. The sensitivity analysis indicated stable results, and no publication bias was observed based on the results of Funnel plot analysis and Egger’s test (p = 0.26).ConclusionsThis meta-analysis suggested that consumption of dietary flavonoids and subtypes (isoflavones, flavonols) has a protective effect against ovarian cancer with a reduced risk of ovarian cancer except for flavones consumption. Nevertheless, further investigations on a larger population covering more flavonoid subclasses are warranted.
Highlights
Ovarian cancer remains a highly lethal malignancy in the world, which has been a serious risk factor of health and safety for women, and a majority of patients are diagnosed in late stages of this disease [1,2]
Previous studies have indicated that intake of dietary flavonoids or flavonoid subclasses is associated with the ovarian cancer risk, but presented controversial results
We observed that intake of dietary flavonoids can decrease ovarian cancer risk, which was demonstrated by pooled relative risks (RRs) (RR = 0.82, 95% confidence intervals (CIs) = 0.68–0.98)
Summary
Ovarian cancer remains a highly lethal malignancy in the world, which has been a serious risk factor of health and safety for women, and a majority of patients are diagnosed in late stages of this disease [1,2]. Studies have demonstrated that the different pharmacological activities of dietary flavonoids on ovarian cancer depend on their structure [13]. Based on the range and structural complexity, dietary flavonoids in all food of plant can be categorized into six major subclasses as followed: flavones, isoflavones, flavonol, flavanones, anthocyanidins and flavan-3-ols [14,15], of which flavones, isoflavones and flavonols are reported in the highest amounts of consumption in the human diet and have biological activity on ovarian cancer [16,17,18,19,20]. Previous studies have indicated that intake of dietary flavonoids or flavonoid subclasses is associated with the ovarian cancer risk, but presented controversial results. We conducted a meta-analysis to derive a more precise estimation of these associations
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