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Intake of the Total, Classes, and Subclasses of (Poly)Phenols and Risk of Prostate Cancer: A Prospective Analysis of the EPIC Study
by Enrique Almanza-Aguilera 1ORCID,Daniel Guiñón-Fort 1,Aurora Perez-Cornago 2,Miriam Martínez-Huélamo 3,4ORCID,Cristina Andrés-Lacueva 3,4ORCID,Anne Tjønneland 5,6ORCID,Anne Kirstine Eriksen 5,Verena Katzke 7,Rashmita Bajracharya 7ORCID,Matthias B. Schulze 8,9ORCID,Giovanna Masala 10ORCID,Andreina Oliverio 11ORCID,Rosario Tumino 12ORCID,Luca Manfredi 13,Cristina Lasheras 14,Marta Crous-Bou 1,Maria-José Sánchez 15,16,17,18ORCID,Pilar Amiano 17,19,20,Sandra M. Colorado-Yohar 17,21,22ORCID,Marcela Guevara 17,23,24ORCID,add Show full author list
1
Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
2
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
3
Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Nutrition and Food Safety Research Institute (INSA), Food Innovation Network (XIA), Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
4
Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
5
Danish Cancer Society Research Center, Danish Cancer Society, 2100 Copenhagen, Denmark
6
Department of Public Health, University of Copenhagen, 2177 Copenhagen, Denmark
7
Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
8
Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
9
Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
10
Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network—ISPRO, 50139 Florence, Italy

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Author to whom correspondence should be addressed.
Cancers 2023, 15(16), 4067; https://doi.org/10.3390/cancers15164067
Received: 26 June 2023 / Revised: 8 August 2023 / Accepted: 10 August 2023 / Published: 11 August 2023
(This article belongs to the Special Issue Prostate Cancer Epidemiology and Lifestyle Factors)
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Simple Summary
(Poly)phenols are bioactive compounds naturally present in plant-based foods, but they have been suggested to increase the prostate cancer risk in retrospective case-control studies. Therefore, our aim was to prospectively evaluate these associations, including clinically relevant subtypes of prostate cancer. We investigated them using the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, a large observational study including 131,425 adult men from seven European countries. During 14 years of follow-up, a total of 6939 incident prostate cancer cases were identified. Overall, no statistically significant associations were observed between the baseline intake of any class and subclass of (poly)phenols and the risk of overall and any subtype of prostate cancer. In conclusion, the consumption of (poly)phenols and (poly)phenol-rich foods does not increase the risk of prostate cancer and can be included as part of a healthy diet.
Abstract
Existing epidemiological evidence regarding the potential role of (poly)phenol intake in prostate cancer (PCa) risk is scarce and, in the case of flavonoids, it has been suggested that their intake may increase PCa risk. We investigated the associations between the intake of the total and individual classes and subclasses of (poly)phenols and the risk of PCa, including clinically relevant subtypes. The European Prospective Investigation into Cancer and Nutrition (EPIC) cohort included 131,425 adult men from seven European countries. (Poly)phenol intake at baseline was assessed by combining validated center/country-specific dietary questionnaires and the Phenol-Explorer database. Multivariable-adjusted Cox proportional hazards models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI). In total, 6939 incident PCa cases (including 3501 low-grade and 710 high-grade, 2446 localized and 1268 advanced, and 914 fatal Pca cases) were identified during a mean follow-up of 14 years. No associations were observed between the total intake of (poly)phenols and the risk of PCa, either overall (HRlog2 = 0.99, 95% CI 0.94–1.04) or according to PCa subtype. Null associations were also found between all classes (phenolic acids, flavonoids, lignans, and stilbenes) and subclasses of (poly)phenol intake and the risk of PCa, overall and according to PCa subtype. The results of the current large prospective cohort study do not support any association between (poly)phenol intake and PCa incidence.
Keywords: polyphenols; diet; intake; prostate cancer; cohort; EPIC