Polyphenol Intake and Epithelial Ovarian Cancer Risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study.

Catalina Montoya Londoño ,Annika Idahl,José María Huerta,Emily Sonestedt,Anne Tjønneland,Charlotta Rylander,Nasser Laouali,Rosario Tumino,Valerie Cayssials,Hanna Sartor,Anja Olsen,Vittorio Krogh,Antonio Agudo,Verena Katzke,Pilar Amiano,Marina Kvaskoff,Maria Santucci De Magistris,Augustin Scalbert,Guri Skeie,Elisabete Weiderpass,Domenico Palli,Kim Overvad,Anders Esberg,Fulvio Ricceri,Aurelio Barricarte,Matthias B Schulze ,Izar Villasante ,María José Sánchez ,Marta Crous‐Bou ,Yahya Mahamat‐Saleh ,Inger Torhild Gram ,Renée T Fortner ,Raúl Zamora-Ros

doi:10.3390/antiox10081249

Abstract

Despite some epidemiological evidence on the protective effects of polyphenol intake on epithelial ovarian cancer (EOC) risk from case-control studies, the evidence is scarce from prospective studies and non-existent for several polyphenol classes. Therefore, we aimed to investigate the associations between the intake of total, classes and subclasses of polyphenols and EOC risk in a large prospective study. The study was conducted in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which included 309,129 adult women recruited mostly from the general population. Polyphenol intake was assessed through validated country-specific dietary questionnaires and the Phenol-Explorer database. During a mean follow-up of 14 years, 1469 first incident EOC cases (including 806 serous, 129 endometrioid, 102 mucinous, and 67 clear cell tumours) were identified. In multivariable-adjusted Cox regression models, the hazard ratio in the highest quartile of total polyphenol intake compared with the lowest quartile (HRQ4vsQ1) was 1.14 (95% CI 0.94–1.39; p-trend = 0.11). Similarly, the intake of most classes and subclasses of polyphenols were not related to either overall EOC risk or any EOC subtype. A borderline statistically significant positive association was observed between phenolic acid intake (HRQ4vsQ1 = 1.20, 95% CI 1.01–1.43; p-trend = 0.02) and EOC risk, especially for the serous subtype and in women with obesity, although these associations did not exceed the Bonferroni correction threshold. The current results do not support any association between polyphenol intake and EOC in our large European prospective study. Results regarding phenolic acid intake need further investigation

Highlights

Ovarian cancer is the seventh most common cancer worldwide in women, and it is the most lethal gynaecological malignancy [1]
Phenolic acids were the main contributors to total polyphenols (50.5%), followed by flavonoids (45.4%), other minor polyphenol classes (3.8%), lignans (0.16%) and stilbenes (0.14%)
No statistically significant association was observed between the extreme quartiles of the intake of total polyphenols (HRQ4vsQ1 = 1.14, 95% CI 0.94–1.39; p-trend = 0.11) and flavonoids (HRQ4vsQ1 = 1.06, 95% CI 0.88–1.29; p-trend = 0.50) and the risk of epithelial ovarian cancer (EOC)

Summary

Introduction

Ovarian cancer is the seventh most common cancer worldwide in women, and it is the most lethal gynaecological malignancy [1]. There are relatively few protective/risk factors that have been established for EOC, especially hormonal and reproductive factors (e.g., parity and oral contraceptive use) [3], recent studies have reported different risk factor profiles (e.g., body fatness [4] and smoking [5]) by tumour histotype [3]. Dietary factors, such as a plant-based diet, have been suggested to play a role in EOC aetiology, until now epidemiological evidence is still limited and mainly inconclusive [6]

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