Phyto-oestrogens and colorectal cancer risk: a systematic review and dose-response meta-analysis of observational studies
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Phyto-oestrogens and colorectal cancer risk: a systematic review and dose-response meta-analysis of observational studies. / Jiang, Ruijingfang; Botma, Akke; Rudolph, Anja; Hüsing, Anika; Chang-Claude, Jenny.
in: BRIT J NUTR, Jahrgang 116, Nr. 12, 12.2016, S. 2115-2128.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Phyto-oestrogens and colorectal cancer risk: a systematic review and dose-response meta-analysis of observational studies
AU - Jiang, Ruijingfang
AU - Botma, Akke
AU - Rudolph, Anja
AU - Hüsing, Anika
AU - Chang-Claude, Jenny
PY - 2016/12
Y1 - 2016/12
N2 - Epidemiological studies suggest that soya consumption as a source of phyto-oestrogens and isoflavones may be associated with a reduced risk of colorectal cancer. However, findings have not yet been synthesised for all groups of phyto-oestrogens. A meta-analysis was conducted to quantify the association between phyto-oestrogens and colorectal cancer risk. Relevant observational studies published up to June 2016 were identified by searching MEDLINE, EMBASE and Cochrane Library databases. Study-specific relative risks (RR) were pooled in both categorical and dose-response meta-analyses. Out of seventeen identified studies, sixteen were included in the meta-analysis. Comparing the highest with the lowest intake category, inverse associations for phyto-oestrogens overall and by subgroup were observed but were statistically significant in case-controls studies and not in cohort studies. The pooled RR in case-control studies were 0·76 (95 % CI 0·69, 0·84), 0·77 (95 % CI 0·69, 0·85) and 0·70 (95 % CI 0·56, 0·89) for phyto-oestrogens, isoflavones and lignans, respectively, whereas the corresponding pooled RR were 0·95 (95 % CI 0·85, 1·06), 0·94 (95 % CI 0·84, 1·05) and 1·00 (95 % CI 0·64, 1·57) in cohort studies. Dose-response analysis yielded an 8 % reduced risk of colorectal neoplasms for every 20 mg/d increase in isoflavones intake in Asians (pooled RR 0·92; 95 % CI 0·86, 0·97). A non-linear inverse association with colorectal cancer risk was found for lignans intake, but no association for circulating enterolactone concentrations was observed. Thus, study heterogeneity precludes a rigorous conclusion regarding an effect of high exposure to isoflavones on risk of colorectal cancer. Current evidence for an association with lignans exposure is limited. Further prospective studies, particularly evaluating lignans, are warranted to clarify the association between different phyto-oestrogens and colorectal cancer risk.
AB - Epidemiological studies suggest that soya consumption as a source of phyto-oestrogens and isoflavones may be associated with a reduced risk of colorectal cancer. However, findings have not yet been synthesised for all groups of phyto-oestrogens. A meta-analysis was conducted to quantify the association between phyto-oestrogens and colorectal cancer risk. Relevant observational studies published up to June 2016 were identified by searching MEDLINE, EMBASE and Cochrane Library databases. Study-specific relative risks (RR) were pooled in both categorical and dose-response meta-analyses. Out of seventeen identified studies, sixteen were included in the meta-analysis. Comparing the highest with the lowest intake category, inverse associations for phyto-oestrogens overall and by subgroup were observed but were statistically significant in case-controls studies and not in cohort studies. The pooled RR in case-control studies were 0·76 (95 % CI 0·69, 0·84), 0·77 (95 % CI 0·69, 0·85) and 0·70 (95 % CI 0·56, 0·89) for phyto-oestrogens, isoflavones and lignans, respectively, whereas the corresponding pooled RR were 0·95 (95 % CI 0·85, 1·06), 0·94 (95 % CI 0·84, 1·05) and 1·00 (95 % CI 0·64, 1·57) in cohort studies. Dose-response analysis yielded an 8 % reduced risk of colorectal neoplasms for every 20 mg/d increase in isoflavones intake in Asians (pooled RR 0·92; 95 % CI 0·86, 0·97). A non-linear inverse association with colorectal cancer risk was found for lignans intake, but no association for circulating enterolactone concentrations was observed. Thus, study heterogeneity precludes a rigorous conclusion regarding an effect of high exposure to isoflavones on risk of colorectal cancer. Current evidence for an association with lignans exposure is limited. Further prospective studies, particularly evaluating lignans, are warranted to clarify the association between different phyto-oestrogens and colorectal cancer risk.
KW - Adenoma
KW - Animals
KW - Colorectal Neoplasms
KW - Evidence-Based Medicine
KW - Female
KW - Functional Food
KW - Healthy Diet
KW - Humans
KW - Incidence
KW - Isoflavones
KW - Lignans
KW - Male
KW - Observational Studies as Topic
KW - Phytoestrogens
KW - Reproducibility of Results
KW - Risk
KW - Sex Factors
KW - Soy Foods
KW - Comparative Study
KW - Journal Article
KW - Meta-Analysis
KW - Review
U2 - 10.1017/S0007114516004360
DO - 10.1017/S0007114516004360
M3 - SCORING: Journal article
C2 - 28091359
VL - 116
SP - 2115
EP - 2128
JO - BRIT J NUTR
JF - BRIT J NUTR
SN - 0007-1145
IS - 12
ER -