Flavonoid and lignan intake and pancreatic cancer risk in the European prospective investigation into cancer and nutrition cohort

Research output: Contribution to journalArticle


Despite the potential cancer preventive effects of flavonoids and lignans, their ability to reduce pancreatic cancer risk has not been demonstrated in epidemiological studies. Our aim was to examine the association between dietary intakes of flavonoids and lignans and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 865 exocrine pancreatic cancer cases occurred after 11.3 years of follow-up of 477,309 cohort members. Dietary flavonoid and lignan intake was estimated through validated dietary questionnaires and the US Department of Agriculture (USDA) and Phenol Explorer databases. Hazard ratios (HR) and 95% confidence intervals (CIs) were calculated using age, sex and center-stratified Cox proportional hazards models, adjusted for energy intake, body mass index (BMI), smoking, alcohol and diabetes status. Our results showed that neither overall dietary intake of flavonoids nor of lignans were associated with pancreatic cancer risk (multivariable-adjusted HR for a doubling of intake = 1.03, 95% CI: 0.95–1.11 and 1.02; 95% CI: 0.89–1.17, respectively). Statistically significant associations were also not observed by flavonoid subclasses. An inverse association between intake of flavanones and pancreatic cancer risk was apparent, without reaching statistical significance, in microscopically confirmed cases (HR for a doubling of intake = 0.96, 95% CI: 0.91–1.00). In conclusion, we did not observe an association between intake of flavonoids, flavonoid subclasses or lignans and pancreatic cancer risk in the EPIC cohort.


  • Esther Molina-Montes
  • María José Sánchez
  • Raul Zamora-Ros
  • H. Bas Bueno-de-Mesquita
  • Petra A. Wark
  • Mireia Obon-Santacana
  • Tilman Kühn
  • Verena Katzke
  • Ruth C. Travis
  • Weimin Ye
  • Malin Sund
  • Alessio Naccarati
  • Amalia Mattiello
  • Vittorio Krogh
  • Caterina Martorana
  • Giovanna Masala
  • Pilar Amiano
  • José María Huerta
  • Aurelio Barricarte
  • José Ramón Quirós
  • Elisabete Weiderpass
  • Lene Angell Åsli
  • Guri Skeie
  • Petra H. Peeters
  • Isabelle Romieu
  • Augustin Scalbert
  • Kim Overvad
  • Matthias Clemens
  • Heiner Boeing
  • Antonia Trichopoulou
  • Eleni Peppa
  • Pavlos Vidalis
  • Kay Tee Khaw
  • Nick Wareham
  • Anja Olsen
  • Anne Tjønneland
  • Marie Christine Boutroun-Rualt
  • Françoise Clavel-Chapelon
  • Amanda J. Cross
  • Yunxia Lu
  • Elio Riboli
  • Eric J. Duell
External organisations
  • CIBER Epidemiology and Public Health (CIBERESP)
  • International Agency for Research on Cancer, World Health Organization
  • University of Malaya
  • Imperial College London
  • Catalan Institute of Oncology
  • German Cancer Research Centre
  • University of Oxford
  • Umeå University
  • Human Genetics Foundation (HuGeF)
  • University of Naples Federico II
  • Istituto Nazionale dei Tumori
  • Azienda Sanitaria Provinciale di Ragusa
  • Cancer Research and Prevention Institute (ISPO)
  • Biodonostia Health Research Institute
  • Murcia Regional Health Council
  • Health Research Institute of Navarra (IDISNA)
  • Public Health Directorate
  • Folkhälsan Research Center
  • UiT The Arctic University of Norway, Tromsø
  • University Medical Center Utrecht
  • Aarhus University
  • German Institute of Human Nutrition
  • National and Kapodistrian University of Athens
  • Hellenic Health Foundation, Athens
  • University of Cambridge
  • MRC Human Nutrition Research
  • Danish Cancer Society Research Center
  • Centre for Research in Epidemiology and Population Health (CESP)
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology
  • Public Health, Global Health, Social Medicine and Epidemiology


  • cohort, diet, flavonoids, lignans, pancreatic cancer
Original languageEnglish
Pages (from-to)1480-1492
Number of pages13
JournalInternational Journal of Cancer
Issue number7
Publication statusPublished - 2016 Oct 1
Publication categoryResearch