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American Journal of Epidemiology Advance Access originally published online on August 9, 2007
American Journal of Epidemiology 2007 166(8):924-931; doi:10.1093/aje/kwm172
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Flavonols and Pancreatic Cancer Risk

The Multiethnic Cohort Study

Ute Nöthlings1,2, Suzanne P. Murphy1, Lynne R. Wilkens1, Brian E. Henderson3 and Laurence N. Kolonel1

1 Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI
2 Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
3 Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA

Correspondence to Dr. Ute Nöthlings, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert Allee 114-116, 14558 Nuthetal, Germany (e-mail: ute.noethlings{at}dife.de).

Received for publication February 15, 2007. Accepted for publication May 8, 2007.

Only a few prospective studies have investigated flavonols as risk factors for cancer, none of which has included pancreatic cancer. The latter is usually fatal, rendering knowledge about prevention particularly important. The authors estimated intakes of three flavonols—quercetin, kaempferol, and myricetin—for 183,518 participants in the Multiethnic Cohort Study and examined associations with incidence of pancreatic cancer. Baseline data were collected in Hawaii and California in 1993–1996. Diet was assessed by using a quantitative food frequency questionnaire. During 8 years of follow-up, 529 cases of exocrine pancreatic cancer occurred. Multivariate Cox regression models were calculated to estimate relative risks. Intake of total flavonols was associated with a reduced pancreatic cancer risk (relative risk for the highest vs. lowest quintile = 0.77, 95% confidence interval: 0.58, 1.03; p trend = 0.046). Of the three individual flavonols, kaempferol was associated with the largest risk reduction (relative risk = 0.78, 95% confidence interval: 0.58, 1.05; p trend = 0.017). Total flavonols, quercetin, kaempferol, and myricetin were all associated with a significant inverse trend among current smokers (relative risks for the highest vs. lowest quartile = 0.41, 0.55, 0.27, 0.55, respectively) but not never or former smokers. This study provides evidence for a preventive effect of flavonols on pancreatic cancer, particularly for current smokers.

diet; flavonols; pancreatic neoplasms; prospective studies


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