Flavonoid intake and liver cancer: a case–control study in Greece

Abstract

In the context of a case-control study undertaken in Greece, we examined the role of six flavonoid classes in the etiology of hepatocellular carcinoma (HCC), by viral status, and of cholangiocarcinoma (CAC). Data and blood samples were collected between 1995 and 1998. Information about dietary intakes and covariates, including chronic infection with hepatitis B (HBV) and C (HCV) virus, were available for 250 HBV and/or HCV positive HCC cases, 83 HBV and HCV negative HCC cases, six CAC cases, and 360 hospital controls. In logistic regression models including gender, age, education, tobacco smoking, and total energy intake, there were no distinct patterns with respect to either HCC virus positive and HCC virus negative in relation to total flavonoids or any class of flavonoids, with the exception of flavones. Flavone intake, mostly derived from spinach and peppers, was inversely associated with both virus positive (P-trend, 0.049) and virus negative (P-trend, 0.084) HCC. There was also a suggestion of an inverse association of CAC with flavan-3-ols, anthocyanidins, and total flavonoids which, however, has to be taken with due caution on account of the small number of cases of this rare tumor. We conclude that flavones may be inversely associated with HCC risk, irrespective of its dominant etiology (viral or non viral).

Risk Factors of Hepatocellular Carcinoma - Current Status and Perspectives

“…Sharp et al reported a reduced risk of HCC in Japanese atomic bomb survivors with frequent soya food consumption (Sharp et al, 2005). The relation between some nutrients intake and HCC risk were investigated, among which favorable effect were reported including flavonoid (Lagiou et al, 2008), β-carotene (Polesel et al, 2007), retinoids (Yuan et al, 2006), selenium (Yu et al, 1991), etc.…”

Proanthocyanidins and the risk of colorectal cancer in Italy

“…This favorable effect may be attributed to specific vitamins, micronutrients, or bioactive compounds contained in plant foods. Flavonoids, a large group of phytochemicals with a similar structure, naturally occurring in foods and beverages of plant origin, have been inversely related to the risk of various cancers of the digestive tract [6][7][8][9][10][11][12][13].…”

Dietary flavonoid, lignan and antioxidant capacity and risk of hepatocellular carcinoma in the European prospective investigation into cancer and nutrition study

“…To our knowledge, there is only one case-control study published from Greece evaluating the association between total flavonoid intake and HCC cancer risk, by hepatitis status. 19 The study showed that flavones and their main food sources (spinach and peppers) were significantly and inversely associated with HCC risk. However, in our cohort study, total flavonoids and flavanols (flavan-3-ol monomers and theaflavins), but not flavones, were inversely related to HCC.…”

“…In a Greek case-control study, flavone intake was inversely associated with HCC risk in both chronic hepatitis virus positive (highest versus lowest quintile, OR 5 0.50, 95% CI: 0.27-0.94; p trend 5 0.049) and negative cases (highest versus lowest quintile, OR 5 0.41, 95% CI: 0.16-1.06; p trend 5 0.084). 19 Furthermore, there is some evidence suggesting that fruits, the main food source of flavonoids in Western diets, 20 protect against HCC. 5 To our knowledge, there are no studies evaluating the association between NEAC and HCC risk.…”