Intake of dietary flavonoids and risk of epithelial ovarian cancer

Aedin Cassidy, Tianyi Huang, Megan S. Rice, Eric Rimm, Shelley S. Tworoger

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Background: The impact of different dietary flavonoid sub-classes on risk of epithelial ovarian cancer is unclear, with the limited previous studies focusing on only a few compounds.
Objective: We prospectively examined the associations between habitual flavonoid sub-class intake and risk of ovarian cancer.
Design: We followed 171,940 Nurses’ Health Study (NHS) and NHSII participants to examine associations between intake of total flavonoids and their sub-classes (flavanones, flavonols, anthocyanins, flavan-3-ols, flavones and polymeric flavonoids) and the risk of ovarian cancer using Cox proportional hazards models. Intake was calculated from validated food frequency questionnaires collected every 4 years.
Results: During 16-22 years of follow-up, 723 cases of ovarian cancer were confirmed through medical records. In pooled multivariate-adjusted analyses, total flavonoids were not statistically significantly associated with ovarian cancer risk (hazard ratio (HR), top versus bottom quintile: 0.85; 95% confidence interval (CI): 0.66, 1.09; p-trend=0.17). However participants in the highest quintile of flavonol and flavanone intakes had a modestly lower risk of ovarian cancer compared with the lowest quintile although the p-trend was not significant (HR: 0.76; 95% CI: 0.59, 0.98; p-trend=0.11 and HR: 0.79; 95% CI: 0.63,1.00; p-trend=0.26, respectively). The association for flavanone intake was stronger for serous invasive/poorly differentiated tumors (comparable HR: 0.68; 95%CI: 0.50, 0.92; p-heterogeneity=0.10; p-trend 0.07) compared to non-serous/less aggressive tumors. Intakes of other sub-classes were not significantly associated with risk. In food-based analyses, comparing those who consumed black tea >1/day versus ≤1/day, the HR was 0.68 (95% CI: 0.51, 0.90; p<0.01).
Conclusions: A higher intake of flavonols and flavanones, as well as black tea consumption may be associated with lower risk of ovarian cancer. Further prospective studies are required to confirm these findings.
Original languageEnglish
Pages (from-to)1344-1351
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Issue number5
Early online date20 Aug 2014
Publication statusPublished - Nov 2014

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